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)

Deza, Diego Casas ; Alcedo, Javier ; Lafuente, Miguel (Universidad de Zaragoza) ; López, F. Javier (Universidad de Zaragoza) ; 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. ;

Resumen: 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.

Idioma: Inglés

DOI: 10.14309/ajg.0000000000003351

Año: 2025

Publicado en: American Journal of Gastroenterology 120, 11 (2025), 2644-2659
ISSN: 0002-9270

Tipo y forma: Article (PostPrint)

Área (Departamento): Área Estadís. Investig. Opera. (Dpto. Métodos Estadísticos)
Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)