Therapeutic regimens against infection without proton pump inhibitors in patients with corpus atrophic gastritis: a real-life single-centre longitudinal observational study
Background: Efficacy of eradication regimens in Helicobacter pylori (Hp) infection is commonly reported with proton pump inhibitors (PPIs). In patients with corpus atrophic gastritis, characterized by impaired acid secretion, PPI treatment is questionable. Objectives: The current study aimed to asse...
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SAGE Publishing
2025-01-01
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| Series: | Therapeutic Advances in Gastroenterology |
| Online Access: | https://doi.org/10.1177/17562848241308035 |
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| author | Emanuele Dilaghi Lorenzo Mosciatti Ludovica Dottori Irene Ligato Gianluca Esposito Emanuela Pilozzi Bruno Annibale Edith Lahner |
| author_facet | Emanuele Dilaghi Lorenzo Mosciatti Ludovica Dottori Irene Ligato Gianluca Esposito Emanuela Pilozzi Bruno Annibale Edith Lahner |
| author_sort | Emanuele Dilaghi |
| collection | DOAJ |
| description | Background: Efficacy of eradication regimens in Helicobacter pylori (Hp) infection is commonly reported with proton pump inhibitors (PPIs). In patients with corpus atrophic gastritis, characterized by impaired acid secretion, PPI treatment is questionable. Objectives: The current study aimed to assess in clinical practice the tolerability and eradication rate of modified eradication regimens without PPI as first-line treatment in patients with histologically Hp-positive corpus atrophic gastritis. Design: Real-life longitudinal observational study. Methods: Overall, 76 patients (77.6% females, age 58.5 (26–88) years) with histologically Hp-positive corpus atrophic gastritis were consecutively diagnosed (2001–2022). First-line eradication treatment was prescribed without PPIs: concomitant or sequential amoxicillin-based therapy (ABT) until 2016 ( n = 30), then single-pill bismuth treatment (SPBT; n = 46). Treatment adherence and adverse events were clinically evaluated and treatment efficacy was assessed by histopathology (updated Sydney system) at 6 ± 3 months after treatment. Results: Only mild adverse events not requiring medical treatment were observed in four patients treated with SPBT without PPIs (vomiting, self-limiting diarrhoea, nausea, abdominal discomfort) and in two treated with ABT without PPIs (vomiting and abdominal discomfort). Overall, 71/76 (93.4%) corpus atrophic gastritis patients completed the treatment: 43/46 (93.5%) SPBT without PPIs and 28/30 (93.3%) ABT without PPIs. Successful cure of Hp was observed in 64/71 patients: overall eradication rate 90.1%, 95%CI 69.4%–115.1%. 42/43 corpus atrophic gastritis patients treated with SPBT without PPIs were successfully cured against 22/28 of those treated with ABT without PPIs. The eradication rate was higher for SPBT than ABT: 97.7%, 95%CI 70.4%–132.0% vs 78.6%, 95%CI 49.2%–118.9%, p = 0.013. Conclusion: In clinical practice, Hp cure can be achieved without PPIs as first-line treatment in about 90% of patients with corpus atrophic gastritis. |
| format | Article |
| id | doaj-art-b59e712a78d04a1db48e6692e991a235 |
| institution | Kabale University |
| issn | 1756-2848 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Gastroenterology |
| spelling | doaj-art-b59e712a78d04a1db48e6692e991a2352025-01-15T06:03:31ZengSAGE PublishingTherapeutic Advances in Gastroenterology1756-28482025-01-011810.1177/17562848241308035Therapeutic regimens against infection without proton pump inhibitors in patients with corpus atrophic gastritis: a real-life single-centre longitudinal observational studyEmanuele DilaghiLorenzo MosciattiLudovica DottoriIrene LigatoGianluca EspositoEmanuela PilozziBruno AnnibaleEdith LahnerBackground: Efficacy of eradication regimens in Helicobacter pylori (Hp) infection is commonly reported with proton pump inhibitors (PPIs). In patients with corpus atrophic gastritis, characterized by impaired acid secretion, PPI treatment is questionable. Objectives: The current study aimed to assess in clinical practice the tolerability and eradication rate of modified eradication regimens without PPI as first-line treatment in patients with histologically Hp-positive corpus atrophic gastritis. Design: Real-life longitudinal observational study. Methods: Overall, 76 patients (77.6% females, age 58.5 (26–88) years) with histologically Hp-positive corpus atrophic gastritis were consecutively diagnosed (2001–2022). First-line eradication treatment was prescribed without PPIs: concomitant or sequential amoxicillin-based therapy (ABT) until 2016 ( n = 30), then single-pill bismuth treatment (SPBT; n = 46). Treatment adherence and adverse events were clinically evaluated and treatment efficacy was assessed by histopathology (updated Sydney system) at 6 ± 3 months after treatment. Results: Only mild adverse events not requiring medical treatment were observed in four patients treated with SPBT without PPIs (vomiting, self-limiting diarrhoea, nausea, abdominal discomfort) and in two treated with ABT without PPIs (vomiting and abdominal discomfort). Overall, 71/76 (93.4%) corpus atrophic gastritis patients completed the treatment: 43/46 (93.5%) SPBT without PPIs and 28/30 (93.3%) ABT without PPIs. Successful cure of Hp was observed in 64/71 patients: overall eradication rate 90.1%, 95%CI 69.4%–115.1%. 42/43 corpus atrophic gastritis patients treated with SPBT without PPIs were successfully cured against 22/28 of those treated with ABT without PPIs. The eradication rate was higher for SPBT than ABT: 97.7%, 95%CI 70.4%–132.0% vs 78.6%, 95%CI 49.2%–118.9%, p = 0.013. Conclusion: In clinical practice, Hp cure can be achieved without PPIs as first-line treatment in about 90% of patients with corpus atrophic gastritis.https://doi.org/10.1177/17562848241308035 |
| spellingShingle | Emanuele Dilaghi Lorenzo Mosciatti Ludovica Dottori Irene Ligato Gianluca Esposito Emanuela Pilozzi Bruno Annibale Edith Lahner Therapeutic regimens against infection without proton pump inhibitors in patients with corpus atrophic gastritis: a real-life single-centre longitudinal observational study Therapeutic Advances in Gastroenterology |
| title | Therapeutic regimens against infection without proton pump inhibitors in patients with corpus atrophic gastritis: a real-life single-centre longitudinal observational study |
| title_full | Therapeutic regimens against infection without proton pump inhibitors in patients with corpus atrophic gastritis: a real-life single-centre longitudinal observational study |
| title_fullStr | Therapeutic regimens against infection without proton pump inhibitors in patients with corpus atrophic gastritis: a real-life single-centre longitudinal observational study |
| title_full_unstemmed | Therapeutic regimens against infection without proton pump inhibitors in patients with corpus atrophic gastritis: a real-life single-centre longitudinal observational study |
| title_short | Therapeutic regimens against infection without proton pump inhibitors in patients with corpus atrophic gastritis: a real-life single-centre longitudinal observational study |
| title_sort | therapeutic regimens against infection without proton pump inhibitors in patients with corpus atrophic gastritis a real life single centre longitudinal observational study |
| url | https://doi.org/10.1177/17562848241308035 |
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