Current status of first- and second-line Helicobacter pylori eradication therapy in the metropolitan area: a multicenter study with a large number of patients

Hideki Mori, Hidekazu Suzuki, Fumio Omata, Tatsuhiro Masaoka, Daisuke Asaoka, Kohei Kawakami, Shigeaki Mizuno, Naoto Kurihara, Akihito Nagahara, Nobuhiro Sakaki, Masayoshi Ito, Yo Kawamura, Masayuki Suzuki, Yuji Shimada, Hitoshi Sasaki, Takeshi Matsuhisa, Akira Torii, Toshihiro Nishizawa, Tetsuya Mine, Toshifumi OhkusaTakashi Kawai, Kengo Tokunaga, Shin’ichi Takahashi

Research output: Contribution to journalArticle

Abstract

Background: The environment surrounding Helicobacter pylori eradication treatment is dramatically changing. Recently, vonoprazan, a first-in-class potassium-competitive acid blocker (P-CAB), was introduced onto the market in 2015. The aging of Japan’s demographic structure is becoming pronounced. In this study, we examined the trend of the eradication rate of H. pylori in the metropolitan area and examined factors concerning successful eradication. Methods: We collected data from 20 hospitals in the Tokyo metropolitan area on patients who received first-line eradication therapy with a proton-pump inhibitor (PPI)/P-CAB, amoxicillin, and clarithromycin for 1 week and second-line eradication therapy with a PPI/P-CAB, amoxicillin, and metronidazole for 1 week from 2013 to 2018. The annual eradication rate and associated factors for successful eradication were analyzed. Results: We collected data of 4097 and 3572 patients in the first- and second-line eradication therapies, respectively. The eradication rate decreased from 2013 to 2014 and increased again from 2015 to 2018 with the first-line therapy [the eradication rates in 2013, 2014, 2015, 2016, 2017 and 2018 were 71.8%, 63.7%, 78.5%, 84.6%, 89.7 and 90.1%, respectively, in the per protocol (PP)]. The second-line eradication rates were 90.0%, 82.6%, 88.8%, 87.5%, 91.8% and 90.1% in 2013, 2014, 2015, 2016, 2017 and 2018, respectively, in PP. Vonoprazan was an independent factor for successful eradication in not only first-line, but also second-line eradication. Age over 75 years was an independent factor for eradication failure in both first- and second-line eradication therapies. Conclusion: The eradication rate improved from 2015 to 2018 with the first-line therapy because of the introduction of vonoprazan in the market. The eradication rates with first- and second-line regimens in elderly patients were lower than those in younger patients.

Original languageEnglish
JournalTherapeutic Advances in Gastroenterology
Volume12
DOIs
Publication statusPublished - 2019 Jul 1
Externally publishedYes

Fingerprint

Helicobacter pylori
Multicenter Studies
Potassium
Proton Pump Inhibitors
Amoxicillin
Therapeutics
Acids
Clarithromycin
Tokyo
Metronidazole
Population Dynamics
Japan
1-(5-(2-fluorophenyl)-1-(pyridin-3-ylsulfonyl)-1H-pyrrol-3-yl)-N-methylmethanamine

Keywords

  • amoxicillin
  • clarithromycin
  • Helicobacter pylori
  • metronidazole
  • vonoprazan

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Current status of first- and second-line Helicobacter pylori eradication therapy in the metropolitan area : a multicenter study with a large number of patients. / Mori, Hideki; Suzuki, Hidekazu; Omata, Fumio; Masaoka, Tatsuhiro; Asaoka, Daisuke; Kawakami, Kohei; Mizuno, Shigeaki; Kurihara, Naoto; Nagahara, Akihito; Sakaki, Nobuhiro; Ito, Masayoshi; Kawamura, Yo; Suzuki, Masayuki; Shimada, Yuji; Sasaki, Hitoshi; Matsuhisa, Takeshi; Torii, Akira; Nishizawa, Toshihiro; Mine, Tetsuya; Ohkusa, Toshifumi; Kawai, Takashi; Tokunaga, Kengo; Takahashi, Shin’ichi.

In: Therapeutic Advances in Gastroenterology, Vol. 12, 01.07.2019.

Research output: Contribution to journalArticle

Mori, H, Suzuki, H, Omata, F, Masaoka, T, Asaoka, D, Kawakami, K, Mizuno, S, Kurihara, N, Nagahara, A, Sakaki, N, Ito, M, Kawamura, Y, Suzuki, M, Shimada, Y, Sasaki, H, Matsuhisa, T, Torii, A, Nishizawa, T, Mine, T, Ohkusa, T, Kawai, T, Tokunaga, K & Takahashi, S 2019, 'Current status of first- and second-line Helicobacter pylori eradication therapy in the metropolitan area: a multicenter study with a large number of patients', Therapeutic Advances in Gastroenterology, vol. 12. https://doi.org/10.1177/1756284819858511
Mori, Hideki ; Suzuki, Hidekazu ; Omata, Fumio ; Masaoka, Tatsuhiro ; Asaoka, Daisuke ; Kawakami, Kohei ; Mizuno, Shigeaki ; Kurihara, Naoto ; Nagahara, Akihito ; Sakaki, Nobuhiro ; Ito, Masayoshi ; Kawamura, Yo ; Suzuki, Masayuki ; Shimada, Yuji ; Sasaki, Hitoshi ; Matsuhisa, Takeshi ; Torii, Akira ; Nishizawa, Toshihiro ; Mine, Tetsuya ; Ohkusa, Toshifumi ; Kawai, Takashi ; Tokunaga, Kengo ; Takahashi, Shin’ichi. / Current status of first- and second-line Helicobacter pylori eradication therapy in the metropolitan area : a multicenter study with a large number of patients. In: Therapeutic Advances in Gastroenterology. 2019 ; Vol. 12.
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abstract = "Background: The environment surrounding Helicobacter pylori eradication treatment is dramatically changing. Recently, vonoprazan, a first-in-class potassium-competitive acid blocker (P-CAB), was introduced onto the market in 2015. The aging of Japan’s demographic structure is becoming pronounced. In this study, we examined the trend of the eradication rate of H. pylori in the metropolitan area and examined factors concerning successful eradication. Methods: We collected data from 20 hospitals in the Tokyo metropolitan area on patients who received first-line eradication therapy with a proton-pump inhibitor (PPI)/P-CAB, amoxicillin, and clarithromycin for 1 week and second-line eradication therapy with a PPI/P-CAB, amoxicillin, and metronidazole for 1 week from 2013 to 2018. The annual eradication rate and associated factors for successful eradication were analyzed. Results: We collected data of 4097 and 3572 patients in the first- and second-line eradication therapies, respectively. The eradication rate decreased from 2013 to 2014 and increased again from 2015 to 2018 with the first-line therapy [the eradication rates in 2013, 2014, 2015, 2016, 2017 and 2018 were 71.8{\%}, 63.7{\%}, 78.5{\%}, 84.6{\%}, 89.7 and 90.1{\%}, respectively, in the per protocol (PP)]. The second-line eradication rates were 90.0{\%}, 82.6{\%}, 88.8{\%}, 87.5{\%}, 91.8{\%} and 90.1{\%} in 2013, 2014, 2015, 2016, 2017 and 2018, respectively, in PP. Vonoprazan was an independent factor for successful eradication in not only first-line, but also second-line eradication. Age over 75 years was an independent factor for eradication failure in both first- and second-line eradication therapies. Conclusion: The eradication rate improved from 2015 to 2018 with the first-line therapy because of the introduction of vonoprazan in the market. The eradication rates with first- and second-line regimens in elderly patients were lower than those in younger patients.",
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T1 - Current status of first- and second-line Helicobacter pylori eradication therapy in the metropolitan area

T2 - a multicenter study with a large number of patients

AU - Mori, Hideki

AU - Suzuki, Hidekazu

AU - Omata, Fumio

AU - Masaoka, Tatsuhiro

AU - Asaoka, Daisuke

AU - Kawakami, Kohei

AU - Mizuno, Shigeaki

AU - Kurihara, Naoto

AU - Nagahara, Akihito

AU - Sakaki, Nobuhiro

AU - Ito, Masayoshi

AU - Kawamura, Yo

AU - Suzuki, Masayuki

AU - Shimada, Yuji

AU - Sasaki, Hitoshi

AU - Matsuhisa, Takeshi

AU - Torii, Akira

AU - Nishizawa, Toshihiro

AU - Mine, Tetsuya

AU - Ohkusa, Toshifumi

AU - Kawai, Takashi

AU - Tokunaga, Kengo

AU - Takahashi, Shin’ichi

PY - 2019/7/1

Y1 - 2019/7/1

N2 - Background: The environment surrounding Helicobacter pylori eradication treatment is dramatically changing. Recently, vonoprazan, a first-in-class potassium-competitive acid blocker (P-CAB), was introduced onto the market in 2015. The aging of Japan’s demographic structure is becoming pronounced. In this study, we examined the trend of the eradication rate of H. pylori in the metropolitan area and examined factors concerning successful eradication. Methods: We collected data from 20 hospitals in the Tokyo metropolitan area on patients who received first-line eradication therapy with a proton-pump inhibitor (PPI)/P-CAB, amoxicillin, and clarithromycin for 1 week and second-line eradication therapy with a PPI/P-CAB, amoxicillin, and metronidazole for 1 week from 2013 to 2018. The annual eradication rate and associated factors for successful eradication were analyzed. Results: We collected data of 4097 and 3572 patients in the first- and second-line eradication therapies, respectively. The eradication rate decreased from 2013 to 2014 and increased again from 2015 to 2018 with the first-line therapy [the eradication rates in 2013, 2014, 2015, 2016, 2017 and 2018 were 71.8%, 63.7%, 78.5%, 84.6%, 89.7 and 90.1%, respectively, in the per protocol (PP)]. The second-line eradication rates were 90.0%, 82.6%, 88.8%, 87.5%, 91.8% and 90.1% in 2013, 2014, 2015, 2016, 2017 and 2018, respectively, in PP. Vonoprazan was an independent factor for successful eradication in not only first-line, but also second-line eradication. Age over 75 years was an independent factor for eradication failure in both first- and second-line eradication therapies. Conclusion: The eradication rate improved from 2015 to 2018 with the first-line therapy because of the introduction of vonoprazan in the market. The eradication rates with first- and second-line regimens in elderly patients were lower than those in younger patients.

AB - Background: The environment surrounding Helicobacter pylori eradication treatment is dramatically changing. Recently, vonoprazan, a first-in-class potassium-competitive acid blocker (P-CAB), was introduced onto the market in 2015. The aging of Japan’s demographic structure is becoming pronounced. In this study, we examined the trend of the eradication rate of H. pylori in the metropolitan area and examined factors concerning successful eradication. Methods: We collected data from 20 hospitals in the Tokyo metropolitan area on patients who received first-line eradication therapy with a proton-pump inhibitor (PPI)/P-CAB, amoxicillin, and clarithromycin for 1 week and second-line eradication therapy with a PPI/P-CAB, amoxicillin, and metronidazole for 1 week from 2013 to 2018. The annual eradication rate and associated factors for successful eradication were analyzed. Results: We collected data of 4097 and 3572 patients in the first- and second-line eradication therapies, respectively. The eradication rate decreased from 2013 to 2014 and increased again from 2015 to 2018 with the first-line therapy [the eradication rates in 2013, 2014, 2015, 2016, 2017 and 2018 were 71.8%, 63.7%, 78.5%, 84.6%, 89.7 and 90.1%, respectively, in the per protocol (PP)]. The second-line eradication rates were 90.0%, 82.6%, 88.8%, 87.5%, 91.8% and 90.1% in 2013, 2014, 2015, 2016, 2017 and 2018, respectively, in PP. Vonoprazan was an independent factor for successful eradication in not only first-line, but also second-line eradication. Age over 75 years was an independent factor for eradication failure in both first- and second-line eradication therapies. Conclusion: The eradication rate improved from 2015 to 2018 with the first-line therapy because of the introduction of vonoprazan in the market. The eradication rates with first- and second-line regimens in elderly patients were lower than those in younger patients.

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KW - clarithromycin

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KW - metronidazole

KW - vonoprazan

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