J Korean Med Sci.  2016 Aug;31(8):1246-1253. 10.3346/jkms.2016.31.8.1246.

Online Registry for Nationwide Database of Current Trend of Helicobacter pylori Eradication in Korea: Interim Analysis

Affiliations
  • 1Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea. jgkimd@cau.ac.kr
  • 2Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
  • 3Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.
  • 4Department of Internal Medicine, Cheonan Hospital, Soon Chun Hyang University College of Medicine, Cheonan, Korea.
  • 5Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
  • 6Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Incheon, Korea.
  • 7Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
  • 8Department of Internal Medicine, Kyungpook National University Medical Center, Daegu, Korea.
  • 9Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea.
  • 10Department of Internal Medicine, Dongguk University College of Medicine Gyeongju Hospital, Gyeongju, Korea.
  • 11Department of Internal Medicine, Pusan Paik Hospital, Inje University College of Medicine, Busan, Korea.
  • 12Department of Gastroenterolgy, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea.
  • 13Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
  • 14Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
  • 15Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
  • 16Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 17Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
  • 18Department of Biomedical Science, Seoul National University Graduate School, Seoul, Korea.
  • 19Cancer Research Institute, Seoul National University, Seoul, Korea.

Abstract

Eradication of Helicobacter pylori using first-line therapy is becoming less effective. Subjects who had been treated for H. pylori infection were prospectively enrolled through an on-line database registry from October 2010 to December 2012. Demographic data, detection methods, treatment indication, regimens, durations, compliance, adverse events, and eradication results for H. pylori infection were collected. Data of 3,700 patients from 34 hospitals were analyzed. The overall eradication rate of the first-line therapy was 73.0%. Eradication failure was significantly associated with old age, concomitant medication, and comorbidity. Regional differences in eradication rates were observed. The most common first-line therapy was proton pump inhibitor-based triple therapy (standard triple therapy, STT) for 7 days (86.8%). The eradication rates varied with regimens, being 73% in STT, 81.8% in bismuth-based quadruple therapy, 100% in sequential therapy, and 90.3% in concomitant therapy. The eradication rate in treatment-naïve patients was higher than that in patients previously treated for H. pylori infection (73.8% vs. 58.5%, P < 0.001). The overall eradication rate for second-line therapy was 84.3%. There was no statistical difference in eradication rates among various regimens. H. pylori eradication rate using STT is decreasing in Korea and has become sub-optimal, suggesting the need for alternative regimens to improve the efficacy of first-line therapy for H. pylori infection.

Keyword

Helicobacter pylori; Eradication Success; First-line Therapy; On-line Registry

MeSH Terms

Adult
Age Factors
Aged
Anti-Bacterial Agents/*therapeutic use
Databases, Factual
Drug Therapy, Combination
Female
Helicobacter Infections/*drug therapy/microbiology
Helicobacter pylori/isolation & purification
Humans
Internet
Logistic Models
Male
Middle Aged
Prospective Studies
Proton Pump Inhibitors/*therapeutic use
Registries
Republic of Korea
Treatment Outcome
Anti-Bacterial Agents
Proton Pump Inhibitors

Figure

  • Fig. 1 Helicobacter pylori eradication in first-line and second-line therapy. A total of 3,700 patients participated in the study. First-line and second-line therapy overall eradication rate was 73.0% and 84.3%, respectively.

  • Fig. 2 Standardized Helicobacter pylori eradication rates in first-line therapy according to residence in Korea. The overall eradication rate in seven regions in Korea was 73.0%. Jeju province showed the highest eradication rate in the first-line therapy, whereas Chungcheong province had the lowest (76.1 vs. 60.3, P < 0.001).


Cited by  2 articles

New Helicobacter pylori Eradication Therapies
Jae Yong Park, Jae Gyu Kim
Korean J Gastroenterol. 2018;72(5):237-244.    doi: 10.4166/kjg.2018.72.5.237.

Eradication Rates of 10-day Sequential Therapy for Helicobacter pylori: Results of an 8-year Prospective Study Conducted at a Tertiary Korean Hospital
Kichul Yoon, Nayoung Kim
Korean J Gastroenterol. 2019;73(2):99-104.    doi: 10.4166/kjg.2019.73.2.99.


Reference

1. Gisbert JP, Calvet X. Review article: the effectiveness of standard triple therapy for Helicobacter pylori has not changed over the last decade, but it is not good enough. Aliment Pharmacol Ther. 2011; 34:1255–1268.
2. Suerbaum S, Michetti P. Helicobacter pylori infection. N Engl J Med. 2002; 347:1175–1186.
3. McColl KE. Clinical practice. Helicobacter pylori infection. N Engl J Med. 2010; 362:1597–1604.
4. Kim MS, Kim N, Kim SE, Jo HJ, Shin CM, Lee SH, Park YS, Hwang JH, Kim JW, Jeong SH, et al. Long-term follow-up Helicobacter pylori reinfection rate and its associated factors in Korea. Helicobacter. 2013; 18:135–142.
5. Fock KM, Talley N, Moayyedi P, Hunt R, Azuma T, Sugano K, Xiao SD, Lam SK, Goh KL, Chiba T, et al. Asia-Pacific consensus guidelines on gastric cancer prevention. J Gastroenterol Hepatol. 2008; 23:351–365.
6. Lim SH, Kwon JW, Kim N, Kim GH, Kang JM, Park MJ, Yim JY, Kim HU, Baik GH, Seo GS, et al. Prevalence and risk factors of Helicobacter pylori infection in Korea: nationwide multicenter study over 13 years. BMC Gastroenterol. 2013; 13:104.
7. Kim N, Kim JJ, Choe YH, Kim HS, Kim JI, Chung IS; Korean College of Helicobacter and Upper Gastrointestinal Research. Korean Association of Gastroenterology. Diagnosis and treatment guidelines for Helicobacter pylori infection in Korea. Korean J Gastroenterol. 2009; 54:269–278.
8. Chey WD, Wong BC; Practice Parameters Committee of the American College of Gastroenterology. American College of Gastroenterology guideline on the management of Helicobacter pylori infection. Am J Gastroenterol. 2007; 102:1808–1825.
9. Kim JM, Kim JS, Jung HC, Kim N, Kim YJ, Song IS. Distribution of antibiotic MICs for Helicobacter pylori strains over a 16-year period in patients from Seoul, South Korea. Antimicrob Agents Chemother. 2004; 48:4843–4847.
10. Cho DK, Park SY, Kee WJ, Lee JH, Ki HS, Yoon KW, Cho SB, Lee WS, Joo YE, Kim HS, et al. The trend of eradication rate of Helicobacter pylori infection and clinical factors that affect the eradication of first-line therapy. Korean J Gastroenterol. 2010; 55:368–375.
11. Choi YS, Cheon JH, Lee JY, Kim SG, Kim JS, Kim N, Lee DH, Kim JM, Jung HC, Song IS. The trend of eradication rates of first-line triple therapy for Helicobacter pylori infection: single center experience for recent eight years. Korean J Gastroenterol. 2006; 48:156–161.
12. Gong EJ, Yun SC, Jung HY, Lim H, Choi KS, Ahn JY, Lee JH, Kim DH, Choi KD, Song HJ, et al. Meta-analysis of first-line triple therapy for Helicobacter pylori eradication in Korea: is it time to change? J Korean Med Sci. 2014; 29:704–713.
13. Georgopoulos SD, Papastergiou V, Karatapanis S. Helicobacter pylori eradication therapies in the era of increasing antibiotic resistance: a paradigm shift to improved efficacy. Gastroenterol Res Pract. 2012; 2012:757926.
14. Graham DY, Shiotani A. New concepts of resistance in the treatment of Helicobacter pylori infections. Nat Clin Pract Gastroenterol Hepatol. 2008; 5:321–331.
15. Chung JW, Lee GH, Han JH, Jeong JY, Choi KS, Kim DH, Jung KW, Choi KD, Song HJ, Jung HY, et al. The trends of one-week first-line and second-line eradication therapy for Helicobacter pylori infection in Korea. Hepatogastroenterology. 2011; 58:246–250.
16. Park JM, Hahm KB. The Korean perspective of Helicobacter pylori infection: lessons from the Japanese government's policy to prevent gastric cancer. Dig Dis. 2014; 32:290–294.
17. Kim SY, Jung SW. Helicobacter pylori eradication therapy in Korea. Korean J Gastroenterol. 2011; 58:67–73.
18. Saracino IM, Zullo A, Holton J, Castelli V, Fiorini G, Zaccaro C, Ridola L, Ricci C, Gatta L, Vaira D. High prevalence of primary antibiotic resistance in Helicobacter pylori isolates in Italy. J Gastrointestin Liver Dis. 2012; 21:363–365.
19. Liu G, Xu X, He L, Ding Z, Gu Y, Zhang J, Zhou L. Primary antibiotic resistance of Helicobacter pylori isolated from Beijing children. Helicobacter. 2011; 16:356–362.
20. Kim JJ, Reddy R, Lee M, Kim JG, El-Zaatari FA, Osato MS, Graham DY, Kwon DH. Analysis of metronidazole, clarithromycin and tetracycline resistance of Helicobacter pylori isolates from Korea. J Antimicrob Chemother. 2001; 47:459–461.
21. Hwang TJ, Kim N, Kim HB, Lee BH, Nam RH, Park JH, Lee MK, Park YS, Lee DH, Jung HC, et al. Change in antibiotic resistance of Helicobacter pylori strains and the effect of A2143G point mutation of 23S rRNA on the eradication of H. pylori in a single center of Korea. J Clin Gastroenterol. 2010; 44:536–543.
22. Kim JY, Kim NY, Kim SJ, Baik GH, Kim GH, Kim JM, Nam RH, Kim HB, Lee DH, Jung HC, et al. Regional difference of antibiotic resistance of Helicobacter pylori strains in Korea. Korean J Gastroenterol. 2011; 57:221–229.
23. Kim N, Kim JM, Kim CH, Park YS, Lee DH, Kim JS, Jung HC, Song IS. Institutional difference of antibiotic resistance of Helicobacter pylori strains in Korea. J Clin Gastroenterol. 2006; 40:683–687.
24. Treiber G, Ammon S, Klotz U. Age-dependent eradication of Helicobacter pylori with dual therapy. Aliment Pharmacol Ther. 1997; 11:711–718.
25. Labenz J, Leverkus F, Börsch G. Omeprazole plus amoxicillin for cure of Helicobacter pylori infection. Factors influencing the treatment success. Scand J Gastroenterol. 1994; 29:1070–1075.
26. Moayyedi P, Chalmers DM, Axon AT. Patient factors that predict failure of omeprazole, clarithromycin, and tinidazole to eradicate Helicobacter pylori . J Gastroenterol. 1997; 32:24–27.
27. Suzuki T, Matsuo K, Sawaki A, Ito H, Hirose K, Wakai K, Sato S, Nakamura T, Yamao K, Ueda R, et al. Systematic review and meta-analysis: importance of CagA status for successful eradication of Helicobacter pylori infection. Aliment Pharmacol Ther. 2006; 24:273–280.
28. Kuepper-Nybelen J, Rothenbacher D, Brenner H. Relationship between lifetime alcohol consumption and Helicobacter pylori infection. Ann Epidemiol. 2005; 15:607–613.
29. Lee JY, Kim N, Kim MS, Choi YJ, Lee JW, Yoon H, Shin CM, Park YS, Lee DH, Jung HC. Factors affecting first-line triple therapy of Helicobacter pylori including CYP2C19 genotype and antibiotic resistance. Dig Dis Sci. 2014; 59:1235–1243.
30. Papastergiou V, Georgopoulos SD, Karatapanis S. Treatment of Helicobacter pylori infection: past, present and future. World J Gastrointest Pathophysiol. 2014; 5:392–399.
31. Lee HJ, Kim JI, Lee JS, Jun EJ, Oh JH, Cheung DY, Chung WC, Kim BW, Kim SS. Concomitant therapy achieved the best eradication rate for Helicobacter pylori among various treatment strategies. World J Gastroenterol. 2015; 21:351–359.
32. Malfertheiner P, Megraud F, O'Morain CA, Atherton J, Axon AT, Bazzoli F, Gensini GF, Gisbert JP, Graham DY, Rokkas T, et al. Management of Helicobacter pylori infection--the Maastricht IV/ Florence Consensus Report. Gut. 2012; 61:646–664.
33. Yoon H, Lee DH, Kim N, Park YS, Shin CM, Kang KK, Oh DH, Jang DK, Chung JW. Meta-analysis: is sequential therapy superior to standard triple therapy for Helicobacter pylori infection in Asian adults? J Gastroenterol Hepatol. 2013; 28:1801–1809.
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