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)

Diego Casas Deza; Javier Alcedo; Miguel Lafuente; F Javier López; Ángeles Perez-Aisa; Matteo Pavoni; Bojan Tepes; Laimas Jonaitis; Manuel Castro-Fernandez; Manuel Pabón-Carrasco; Alma Keco-Huerga; Irina Voynovan; Luis Bujanda; Alfredo J Lucendo; Natasa Brglez Jurecic; Maja Denkovski; Ludmila Vologzanina; Luis Rodrigo; Samuel J Martínez-Domínguez; Galyna Fadieienko; Jose M Huguet; Rustam Abdulkhakov; Sayar R Abdulkhakov; Noelia Alcaide; Benito Velayos; Luis Hernández; Dmitry S Bordin; Antonio Gasbarrini; Juozas Kupcinskas; Gülüstan Babayeva; Oleksiy Gridnyev; Mārcis Leja; Theodore Rokkas; Ricardo Marcos-Pinto; Frode Lerang; Doron Boltin; Antonio Mestrovic; Sinead M Smith; Marino Venerito; Lyudmila Boyanova; Vladimir Milivojevic; Michael Doulberis; Lumir Kunovsky; Pablo Parra; Anna Cano-Català; Leticia Moreira; Olga P Nyssen; Francis Megraud; Colm O Morain; Javier P Gisbert

doi:10.14309/ajg.0000000000003351

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)

Diego Casas Deza
, Javier Alcedo^*
, Miguel Lafuente
, F Javier López
, Ángeles Perez-Aisa
, Matteo Pavoni
, Bojan Tepes
, Laimas Jonaitis
, Manuel Castro-Fernandez
, Manuel Pabón-Carrasco
, Alma Keco-Huerga
, Irina Voynovan
, Luis Bujanda
, Alfredo J Lucendo
, Natasa Brglez Jurecic
, Maja Denkovski
, Ludmila Vologzanina
, Luis Rodrigo
, Samuel J Martínez-Domínguez
, Galyna Fadieienko

Jose M Huguet, Rustam Abdulkhakov, Sayar R Abdulkhakov, Noelia Alcaide, Benito Velayos, Luis Hernández, Dmitry S Bordin, Antonio Gasbarrini, Juozas Kupcinskas, Gülüstan Babayeva, Oleksiy Gridnyev, Mārcis Leja, Theodore Rokkas, Ricardo Marcos-Pinto, Frode Lerang, Doron Boltin, Antonio Mestrovic, Sinead M Smith, Marino Venerito, Lyudmila Boyanova, Vladimir Milivojevic, Michael Doulberis, Lumir Kunovsky, Pablo Parra, Anna Cano-Català, Leticia Moreira, Olga P Nyssen, Francis Megraud, Colm O Morain, Javier P Gisbert

^*Autore corrispondente per questo lavoro

Instituto de Investigación Sanitaria Aragón (IISA)
Miguel Servet University Hospital
University of Zaragoza
Alma Mater Studiorum University of Bologna
Lithuanian University of Health Sciences
Hospital Universitario de Valme
AS Loginov Moscow Clinical Scientific Center
University of the Basque Country
Centro de Investigación Biomédica en Red
Biodonostia Health Research Institute
Interni Oddelek Diagnostic Centre
University of Oviedo
Government Institution L.T.Malaya Therapy National Institute of the National Academy of Medical Sciences of Ukraine
Kazan State Medical University
Hospital Clínico Universitario de Valladolid
Gerencia Regional de Salud de Castilla y León
Azerbaijan State Advanced Training Institute for Doctors
University of Latvia
Henry Dunant Hospital
University of Porto (ICBAS.UP)
University of Porto
University Hospital Center of Santo António
Tel Aviv University
Rabin Medical Center Israel
Split University Hospital
Otto von Guericke University Magdeburg
Medical University Sofia
University of Belgrade
Clinical Center of Serbia
Cantonal Hospital Aarau
University Hospital of Olomouc
Masaryk Memorial Cancer Institute
Masaryk University
Hospital Universitario de la Princesa
Internal Medicine Department
University of Barcelona
Université de Bordeaux

Risultato della ricerca: Contributo in rivista › Articolo

Abstract

INTRODUCTION: – To evaluate the prescription patterns, effectiveness, and safety of adding probiotics to Helicobacter pylori eradication therapy, in Europe. METHODS: – International, prospective, noninterventional 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 (AEs) 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 (odds ratio [OR] 1.631, 95% confidence interval [CI] 1.456–1.828), as well as in triple (OR 1.702, 95% CI 1.403–2.065), quadruple (OR 1.383, 95% CI 0.996–1.920), bismuth quadruple (OR 1.248, 95% CI 1.003–1.554), and sequential therapies (OR 3.690, 95% CI 2.686–5.069). Lactobacillus genus was associated with a higher therapy effectiveness in Eastern Europe when triple (OR 2.625, 95% CI 1.911–3.606) and bismuth quadruple (OR 1.587, 95% 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 (OR 0.656, 95% CI 0.516–0.888) and severe AEs (OR 0.312, 95% CI 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, 95% CI 0.185–0.347) AEs, and Saccharomyces was associated with reduced overall (OR 0.54, 95% CI 0.32–0.91) and severe (OR 0.257, 95% CI 0.123–0.536) AEs under quadruple-bismuth regimen. DISCUSSION: – In Europe, the use of probiotics was associated with higher effectiveness and safety of H. pylori eradication therapy. Lactobacillus improved treatment effectiveness, whereas Bifidobacterium and Saccharomyces were associated with a better safety profile.

Lingua originale	Inglese
pagine (da-a)	2644-2659
Numero di pagine	16
Rivista	THE AMERICAN JOURNAL OF GASTROENTEROLOGY
Volume	120
Numero di pubblicazione	11
DOI	https://doi.org/10.14309/ajg.0000000000003351
Stato di pubblicazione	Pubblicato - 2025

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SDG 3 Salute e benessere

All Science Journal Classification (ASJC) codes

Epatologia
Gastroenterologia

Keywords

effectiveness
eradication therapy
probiotics
safety

Accesso al documento

10.14309/ajg.0000000000003351

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Casas Deza, D., Alcedo, J., Lafuente, M., López, F. J., Perez-Aisa, Á., Pavoni, M., Tepes, B., Jonaitis, L., Castro-Fernandez, M., Pabón-Carrasco, M., Keco-Huerga, A., Voynovan, I., Bujanda, L., Lucendo, A. J., Brglez Jurecic, N., Denkovski, M., Vologzanina, L., Rodrigo, L., Martínez-Domínguez, S. J., ... Gisbert, J. P. (2025). 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). THE AMERICAN JOURNAL OF GASTROENTEROLOGY, 120(11), 2644-2659. https://doi.org/10.14309/ajg.0000000000003351

@article{d2fd254b5d25405e8e58930c1e12702a,

title = "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)",

abstract = "INTRODUCTION: – To evaluate the prescription patterns, effectiveness, and safety of adding probiotics to Helicobacter pylori eradication therapy, in Europe. METHODS: – International, prospective, noninterventional 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 (AEs) 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 (odds ratio [OR] 1.631, 95\% confidence interval [CI] 1.456–1.828), as well as in triple (OR 1.702, 95\% CI 1.403–2.065), quadruple (OR 1.383, 95\% CI 0.996–1.920), bismuth quadruple (OR 1.248, 95\% CI 1.003–1.554), and sequential therapies (OR 3.690, 95\% CI 2.686–5.069). Lactobacillus genus was associated with a higher therapy effectiveness in Eastern Europe when triple (OR 2.625, 95\% CI 1.911–3.606) and bismuth quadruple (OR 1.587, 95\% 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 (OR 0.656, 95\% CI 0.516–0.888) and severe AEs (OR 0.312, 95\% CI 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, 95\% CI 0.185–0.347) AEs, and Saccharomyces was associated with reduced overall (OR 0.54, 95\% CI 0.32–0.91) and severe (OR 0.257, 95\% CI 0.123–0.536) AEs under quadruple-bismuth regimen. DISCUSSION: – In Europe, the use of probiotics was associated with higher effectiveness and safety of H. pylori eradication therapy. Lactobacillus improved treatment effectiveness, whereas Bifidobacterium and Saccharomyces were associated with a better safety profile.",

keywords = "effectiveness, eradication therapy, probiotics, safety, effectiveness, eradication therapy, probiotics, safety",

author = "\{Casas Deza\}, Diego and Javier Alcedo and Miguel Lafuente and L{\'o}pez, \{F Javier\} and {\'A}ngeles Perez-Aisa and Matteo Pavoni and Bojan Tepes and Laimas Jonaitis and Manuel Castro-Fernandez and Manuel Pab{\'o}n-Carrasco and Alma Keco-Huerga and Irina Voynovan and Luis Bujanda and Lucendo, \{Alfredo J\} and \{Brglez Jurecic\}, Natasa and Maja Denkovski and Ludmila Vologzanina and Luis Rodrigo and Mart{\'i}nez-Dom{\'i}nguez, \{Samuel J\} and Galyna Fadieienko and Huguet, \{Jose M\} and Rustam Abdulkhakov and Abdulkhakov, \{Sayar R\} and Noelia Alcaide and Benito Velayos and Luis Hern{\'a}ndez and Bordin, \{Dmitry S\} and Antonio Gasbarrini and Juozas Kupcinskas and G{\"u}l{\"u}stan Babayeva and Oleksiy Gridnyev and Mārcis Leja and Theodore Rokkas and Ricardo Marcos-Pinto and Frode Lerang and Doron Boltin and Antonio Mestrovic and Smith, \{Sinead M\} and Marino Venerito and Lyudmila Boyanova and Vladimir Milivojevic and Michael Doulberis and Lumir Kunovsky and Pablo Parra and Anna Cano-Catal{\`a} and Leticia Moreira and Nyssen, \{Olga P\} and Francis Megraud and Morain, \{Colm O\} and Gisbert, \{Javier P\}",

year = "2025",

doi = "10.14309/ajg.0000000000003351",

language = "English",

volume = "120",

pages = "2644--2659",

journal = "THE AMERICAN JOURNAL OF GASTROENTEROLOGY",

issn = "1572-0241",

publisher = "New York: Elsevier Science",

number = "11",

}

Casas Deza, D, Alcedo, J, Lafuente, M, López, FJ, Perez-Aisa, Á, Pavoni, M, Tepes, B, Jonaitis, L, Castro-Fernandez, M, Pabón-Carrasco, M, Keco-Huerga, A, Voynovan, I, Bujanda, L, Lucendo, AJ, Brglez Jurecic, N, Denkovski, M, Vologzanina, L, Rodrigo, L, Martínez-Domínguez, SJ, Fadieienko, G, Huguet, JM, Abdulkhakov, R, Abdulkhakov, SR, Alcaide, N, Velayos, B, Hernández, L, Bordin, DS, Gasbarrini, A, Kupcinskas, J, Babayeva, G, Gridnyev, O, Leja, M, Rokkas, T, Marcos-Pinto, R, Lerang, F, Boltin, D, Mestrovic, A, Smith, SM, Venerito, M, Boyanova, L, Milivojevic, V, Doulberis, M, Kunovsky, L, Parra, P, Cano-Català, A, Moreira, L, Nyssen, OP, Megraud, F, Morain, CO & Gisbert, JP 2025, '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)', THE AMERICAN JOURNAL OF GASTROENTEROLOGY, vol. 120, n. 11, pagg. 2644-2659. https://doi.org/10.14309/ajg.0000000000003351

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). / Casas Deza, Diego; Alcedo, Javier; Lafuente, Miguel et al.
In: THE AMERICAN JOURNAL OF GASTROENTEROLOGY, Vol. 120, N. 11, 2025, pag. 2644-2659.

Risultato della ricerca: Contributo in rivista › Articolo

TY - JOUR

T1 - 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)

AU - Casas Deza, Diego

AU - Alcedo, Javier

AU - Lafuente, Miguel

AU - López, F Javier

AU - Perez-Aisa, Ángeles

AU - Pavoni, Matteo

AU - Tepes, Bojan

AU - Jonaitis, Laimas

AU - Castro-Fernandez, Manuel

AU - Pabón-Carrasco, Manuel

AU - Keco-Huerga, Alma

AU - Voynovan, Irina

AU - Bujanda, Luis

AU - Lucendo, Alfredo J

AU - Brglez Jurecic, Natasa

AU - Denkovski, Maja

AU - Vologzanina, Ludmila

AU - Rodrigo, Luis

AU - Martínez-Domínguez, Samuel J

AU - Fadieienko, Galyna

AU - Huguet, Jose M

AU - Abdulkhakov, Rustam

AU - Abdulkhakov, Sayar R

AU - Alcaide, Noelia

AU - Velayos, Benito

AU - Hernández, Luis

AU - Bordin, Dmitry S

AU - Gasbarrini, Antonio

AU - Kupcinskas, Juozas

AU - Babayeva, Gülüstan

AU - Gridnyev, Oleksiy

AU - Leja, Mārcis

AU - Rokkas, Theodore

AU - Marcos-Pinto, Ricardo

AU - Lerang, Frode

AU - Boltin, Doron

AU - Mestrovic, Antonio

AU - Smith, Sinead M

AU - Venerito, Marino

AU - Boyanova, Lyudmila

AU - Milivojevic, Vladimir

AU - Doulberis, Michael

AU - Kunovsky, Lumir

AU - Parra, Pablo

AU - Cano-Català, Anna

AU - Moreira, Leticia

AU - Nyssen, Olga P

AU - Megraud, Francis

AU - Morain, Colm O

AU - Gisbert, Javier P

PY - 2025

Y1 - 2025

N2 - INTRODUCTION: – To evaluate the prescription patterns, effectiveness, and safety of adding probiotics to Helicobacter pylori eradication therapy, in Europe. METHODS: – International, prospective, noninterventional 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 (AEs) 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 (odds ratio [OR] 1.631, 95% confidence interval [CI] 1.456–1.828), as well as in triple (OR 1.702, 95% CI 1.403–2.065), quadruple (OR 1.383, 95% CI 0.996–1.920), bismuth quadruple (OR 1.248, 95% CI 1.003–1.554), and sequential therapies (OR 3.690, 95% CI 2.686–5.069). Lactobacillus genus was associated with a higher therapy effectiveness in Eastern Europe when triple (OR 2.625, 95% CI 1.911–3.606) and bismuth quadruple (OR 1.587, 95% 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 (OR 0.656, 95% CI 0.516–0.888) and severe AEs (OR 0.312, 95% CI 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, 95% CI 0.185–0.347) AEs, and Saccharomyces was associated with reduced overall (OR 0.54, 95% CI 0.32–0.91) and severe (OR 0.257, 95% CI 0.123–0.536) AEs under quadruple-bismuth regimen. DISCUSSION: – In Europe, the use of probiotics was associated with higher effectiveness and safety of H. pylori eradication therapy. Lactobacillus improved treatment effectiveness, whereas Bifidobacterium and Saccharomyces were associated with a better safety profile.

AB - INTRODUCTION: – To evaluate the prescription patterns, effectiveness, and safety of adding probiotics to Helicobacter pylori eradication therapy, in Europe. METHODS: – International, prospective, noninterventional 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 (AEs) 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 (odds ratio [OR] 1.631, 95% confidence interval [CI] 1.456–1.828), as well as in triple (OR 1.702, 95% CI 1.403–2.065), quadruple (OR 1.383, 95% CI 0.996–1.920), bismuth quadruple (OR 1.248, 95% CI 1.003–1.554), and sequential therapies (OR 3.690, 95% CI 2.686–5.069). Lactobacillus genus was associated with a higher therapy effectiveness in Eastern Europe when triple (OR 2.625, 95% CI 1.911–3.606) and bismuth quadruple (OR 1.587, 95% 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 (OR 0.656, 95% CI 0.516–0.888) and severe AEs (OR 0.312, 95% CI 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, 95% CI 0.185–0.347) AEs, and Saccharomyces was associated with reduced overall (OR 0.54, 95% CI 0.32–0.91) and severe (OR 0.257, 95% CI 0.123–0.536) AEs under quadruple-bismuth regimen. DISCUSSION: – In Europe, the use of probiotics was associated with higher effectiveness and safety of H. pylori eradication therapy. Lactobacillus improved treatment effectiveness, whereas Bifidobacterium and Saccharomyces were associated with a better safety profile.

KW - effectiveness

KW - eradication therapy

KW - probiotics

KW - safety

KW - effectiveness

KW - eradication therapy

KW - probiotics

KW - safety

UR - https://publicatt.unicatt.it/handle/10807/330765

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U2 - 10.14309/ajg.0000000000003351

DO - 10.14309/ajg.0000000000003351

M3 - Article

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ER -

Casas Deza D, Alcedo J, Lafuente M, López FJ, Perez-Aisa Á, Pavoni M et al. 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). THE AMERICAN JOURNAL OF GASTROENTEROLOGY. 2025;120(11):2644-2659. doi: 10.14309/ajg.0000000000003351

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)

Abstract

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