166050 20260418110657.0 doi 10.14309/ajg.0000000000003351 sideral 143049 ART-2025-143049 eng Deza, Diego Casas Probiotics prescribed with Helicobacter Pylori eradication therapy in europe: usage pattern, effectiveness, and safety: results from the European Registry on Helicobacter Pylori Management (Hp-EuReg) 2025 Access copy available to the general public Unrestricted Aim: 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. info:eu-repo/semantics/embargoedAccess by-nc-nd https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es info:eu-repo/semantics/article info:eu-repo/semantics/acceptedVersion Alcedo, Javier Lafuente, Miguel Universidad de Zaragoza (orcid)0000-0001-8471-3224 López, F. Javier Universidad de Zaragoza (orcid)0000-0002-7615-2559 Perez-Aisa, Ángeles Pavoni, Matteo Tepes, Bojan Jonaitis, Laimas Castro-Fernandez, Manuel Pabón-Carrasco, Manuel Keco-Huerga, Alma Voynovan, Irina Bujanda, Luis Lucendo, Alfredo J. Jurecic, Natasa Brglez Denkovski, Maja Vologzanina, Ludmila Rodrigo, Luis Martínez-Domínguez, Samuel J. Universidad de Zaragoza Fadieienko, Galyna Huguet, Jose M. Abdulkhakov, Rustam Abdulkhakov, Sayar R. Alcaide, Noelia Velayos, Benito Hernández, Luis Bordin, Dmitry S. Gasbarrini, Antonio Kupcinskas, Juozas Babayeva, Gülüstan Gridnyev, Oleksiy Leja, Marcis Rokkas, Theodore Marcos-Pinto, Ricardo Lerang, Frode Boltin, Doron Mestrovic, Antonio Smith, Sinead M. Venerito, Marino Boyanova, Lyudmila Milivojevic, Vladimir Doulberis, Michael Kunovsky, Lumir Parra, Pablo Cano-Català, Anna Moreira, Leticia Nyssen, Olga P. Megraud, Francis Morain, Colm O Gisbert, Javier P. 2007 265 Universidad de Zaragoza Dpto. Métodos Estadísticos Área Estadís. Investig. Opera. 1007 610 Universidad de Zaragoza Dpto. Medicina, Psiqu. y Derm. Area Medicina 120, 11 (2025), 2644-2659 Am. j. gastroenterol. American Journal of Gastroenterology 0002-9270 2720298 http://zaguan.unizar.es/record/166050/files/texto_completo.pdf Postprint info:eu-repo/date/embargoEnd/2026-11-01 1537455 http://zaguan.unizar.es/record/166050/files/texto_completo.jpg?subformat=icon icon Postprint info:eu-repo/date/embargoEnd/2026-11-01 oai:zaguan.unizar.es:166050 articulos driver 2026-04-18-11:05:07 ARTICLE