000166050 001__ 166050 000166050 005__ 20260119170325.0 000166050 0247_ $$2doi$$a10.14309/ajg.0000000000003351 000166050 0248_ $$2sideral$$a143049 000166050 037__ $$aART-2025-143049 000166050 041__ $$aeng 000166050 100__ $$aDeza, Diego Casas 000166050 245__ $$aProbiotics prescribed with Helicobacter Pylori eradication therapy in europe: usage pattern, effectiveness, and safety: results from the European Registry on Helicobacter Pylori Management (Hp-EuReg) 000166050 260__ $$c2025 000166050 5060_ $$aAccess copy available to the general public$$fUnrestricted 000166050 5203_ $$aAim: To evaluate the prescriptions patterns, effectiveness, and safety of adding probiotics to Helicobacter pylori eradication therapy, in Europe. Design: International, prospective, non-interventional registry of the clinical practice of the European gastroenterologists. Data were collected and quality reviewed until March 2021 at AEG-REDCap. The effectiveness was evaluated by modified intention-to-treat analysis, differentiating by geographic areas. Adverse events (AE) were categorized as mild, moderate, and severe. Results: Overall, 36,699 treatments were recorded, where 8,233 (22%) were prescribed with probiotics. Probiotics use was associated with higher effectiveness in the overall analysis (OR 1.631 [95% CI 1.456-1.828]), as well as in triple (1.702 [1.403-2.065]), quadruple (1.383 [0.996-1.920]), bismuth quadruple (1.248 [1.003-1.554] and sequential therapies (3.690 [2.686-5.069]). Lactobacillus genus was associated with a higher therapy effectiveness in Eastern Europe when triple (OR: 2.625 [CI 1.911, 3.606]) and bismuth quadruple (OR: 1.587 [CI 1.117, 2.254]) first-line therapies were prescribed. In Central Europe, the use of probiotics was associated with a decrease in both the overall incidence of AEs (0.656 [0.516, 0.888]) as well as severe AEs (0.312; [0.217, 0.449]). Bifidobacterium genus was associated with lower overall (OR: 0.725 [95% CI 0.592-0.888]) and severe (OR: 0.254 [0.185-0.347]) AEs; and Saccharomyces was associated with reduced overall (OR: 0.54 [CI 0.32-0.91]) and severe (OR 0.257 [CI 0.123-0.536]) AEs under quadruple-bismuth regimen. Conclusions: In Europe, the use of probiotics was associated with higher effectiveness and safety of H. pylori eradication therapy. Lactobacillus improved treatment effectiveness, while Bifidobacterium and Saccharomyces were associated with a better safety profile. 000166050 540__ $$9info:eu-repo/semantics/embargoedAccess$$aby-nc-nd$$uhttps://creativecommons.org/licenses/by-nc-nd/4.0/deed.es 000166050 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/acceptedVersion 000166050 700__ $$aAlcedo, Javier 000166050 700__ $$0(orcid)0000-0001-8471-3224$$aLafuente, Miguel$$uUniversidad de Zaragoza 000166050 700__ $$0(orcid)0000-0002-7615-2559$$aLópez, F. Javier$$uUniversidad de Zaragoza 000166050 700__ $$aPerez-Aisa, Ángeles 000166050 700__ $$aPavoni, Matteo 000166050 700__ $$aTepes, Bojan 000166050 700__ $$aJonaitis, Laimas 000166050 700__ $$aCastro-Fernandez, Manuel 000166050 700__ $$aPabón-Carrasco, Manuel 000166050 700__ $$aKeco-Huerga, Alma 000166050 700__ $$aVoynovan, Irina 000166050 700__ $$aBujanda, Luis 000166050 700__ $$aLucendo, Alfredo J. 000166050 700__ $$aJurecic, Natasa Brglez 000166050 700__ $$aDenkovski, Maja 000166050 700__ $$aVologzanina, Ludmila 000166050 700__ $$aRodrigo, Luis 000166050 700__ $$aMartínez-Domínguez, Samuel J.$$uUniversidad de Zaragoza 000166050 700__ $$aFadieienko, Galyna 000166050 700__ $$aHuguet, Jose M. 000166050 700__ $$aAbdulkhakov, Rustam 000166050 700__ $$aAbdulkhakov, Sayar R. 000166050 700__ $$aAlcaide, Noelia 000166050 700__ $$aVelayos, Benito 000166050 700__ $$aHernández, Luis 000166050 700__ $$aBordin, Dmitry S. 000166050 700__ $$aGasbarrini, Antonio 000166050 700__ $$aKupcinskas, Juozas 000166050 700__ $$aBabayeva, Gülüstan 000166050 700__ $$aGridnyev, Oleksiy 000166050 700__ $$aLeja, Marcis 000166050 700__ $$aRokkas, Theodore 000166050 700__ $$aMarcos-Pinto, Ricardo 000166050 700__ $$aLerang, Frode 000166050 700__ $$aBoltin, Doron 000166050 700__ $$aMestrovic, Antonio 000166050 700__ $$aSmith, Sinead M. 000166050 700__ $$aVenerito, Marino 000166050 700__ $$aBoyanova, Lyudmila 000166050 700__ $$aMilivojevic, Vladimir 000166050 700__ $$aDoulberis, Michael 000166050 700__ $$aKunovsky, Lumir 000166050 700__ $$aParra, Pablo 000166050 700__ $$aCano-Català, Anna 000166050 700__ $$aMoreira, Leticia 000166050 700__ $$aNyssen, Olga P. 000166050 700__ $$aMegraud, Francis 000166050 700__ $$aMorain, Colm O 000166050 700__ $$aGisbert, Javier P. 000166050 700__ $$a 000166050 7102_ $$12007$$2265$$aUniversidad de Zaragoza$$bDpto. Métodos Estadísticos$$cÁrea Estadís. Investig. Opera. 000166050 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina 000166050 773__ $$g120, 11 (2025), 2644-2659$$pAm. j. gastroenterol.$$tAmerican Journal of Gastroenterology$$x0002-9270 000166050 8564_ $$s2720298$$uhttps://zaguan.unizar.es/record/166050/files/texto_completo.pdf$$yPostprint$$zinfo:eu-repo/date/embargoEnd/2026-11-01 000166050 8564_ $$s1537455$$uhttps://zaguan.unizar.es/record/166050/files/texto_completo.jpg?subformat=icon$$xicon$$yPostprint$$zinfo:eu-repo/date/embargoEnd/2026-11-01 000166050 909CO $$ooai:zaguan.unizar.es:166050$$particulos$$pdriver 000166050 951__ $$a2026-01-19-14:38:59 000166050 980__ $$aARTICLE