European Registry on the management of Helicobacter pylori infection (Hp-EuReg): analysis of 2360 patients receiving first-line therapy in Russia.

AIM: European Registry on the management of Helicobacter pylori infection («Hp-EuReg¼) - a multicenter prospective observational study initiated by the European Helicobacter and Microbiota Study Group, conducted in 27 European countries in order to evaluate the real clinical practice of diagnosis and treatment of H. pylori and its comparison with international recommendations. MATERIALS AND METHODS: The analysis of 2360 patients entered in the register by the Russian centres of «Hp-EuReg¼ in 2013-2017, who were underwent 1st line eradication therapy. RESULTS: The most common methods of primary diagnosis of H. pylori are histological (37.7%), rapid urease test (29.2%) and serology (29.7%). The duration of eradication therapy in 9.4% of cases was 7 days, in 65.3% - 10 days, and in 25.3% - 14 days. To control the effec- tiveness of treatment, H. pylori antigen in feces (31.3%), urea breath test (23.4%) and histological method (23.3%) were used. In 3.6% cases was used serology by mistake. In 17.3% of patients control was not carried out. The effectiveness of triple therapy with a PPI, amoxicillin, clar- ithromycin (per protocol) was 67.6%, with 7-day course, 81.1% at 10-day and 86.7% at 14-day course. Eradication rate of triple therapy with addition of bismuth (per protocol) reached 90,6% in the group receiving 10-day scheme and 93.6% in the group receiving the 14-day treatment. CONCLUSION: Significant deviations of clinical practice from expert recommendations, most pronounced at the stage of monitoring the effectiveness of therapy, were noted. The suboptimal efficacy of triple therapy is shown.

[European Registry on the management of Helicobacter pylori infection (Hp-EuReg protocol): The first results of Russian centers].

AIM: To assess the clinical practice of diagnosis and treatment in patients with Helicobacter pylori infection and to compare this practice with the international guidelines in the European Registry on the management of Helicobacter pylori infection, Hp-EuReg protocol), a multicenter prospective observational study initiated by the European Helicobacter and Microbiota Study Group. MATERIALs AND METHODS: The data of 813 patients infected with H. pylori and entered in the Hp-EuReg register by the Russian centers in 2013-2015 were analyzed. RESULTS: The most common methods for the primary diagnosis of H. pylori infection are histology (40.3%), rapid urease test (35.7%), and serology (17.2%). The duration of H. pylori eradication therapy was 7, 10, and 14 days in 18.0, 49.3, and 25.1%, respectively. To monitor the effectiveness of treatment, the investigators used a histological examination (34%), a urea breath test (27.3%), H. pylori stool antigen (22.8%), and a rapid urease test (16.3%). A serological test was carried out in 2.5% of the cases. No monitoring was done in 13.5% of the patients. The average eradication efficiency was 82.6%. If the therapy was ineffective, 80% of physicians did not intend to prescribe a new cycle of treatment. CONCLUSION: Significant differences were found between clinical practice and the current guidelines.

COMPARATIVE RESEARCH OF EFFICACY OF MONOTHERAPY WITH UDCA AND THE COMBINATION OF UDCA GIMEKROMONOM C IN PATIENTS WITH BILIARY SLUDGE2 STAGES.

Aim of research: Evaluate clinical advantages of combined therapy using Ursodeoxycholic acid (UDCA) with spasmolytic of patients with second stage biliary sludge (BS) - in a form of echo-heterogeneous bile containing clots. MATERIALS AND METHODS: 42 patients with 2nd stage BS were examined. 1st group (21 patients) was treated by UDCA monotherapy, 2,d group (21 patients) received combined therapy: UDCA with Hymecromone for 4 weeks. 4 week later, clinical and echographical assessment of the therapy provided was conducted. RESULTS: patients who received the combined therapy had more expressed decrease of pain syndrome in the right hypochondrium than those who received the monotherapy. During the study of gallbladder contraction function (GCF) any reliable evidence of its change wasn't found in both groups, thus the combined therapy (UDCA + Hymecromone) does not increase GCF. According to ultrasonography, an improvement of gallbladder content (transition from the 2nd stage BS to the 1st and reduction of an amount and size of clots and suspension) was observed in 81% patients from the Ist group (UDCA), and in 95% patients from the 2nd group (UDCA + Hymecromone). CONCLUSION: research data show increased effectiveness of treatment of patients with 2nd stage BS while using the combi- nation of UDCA and Hymecromone.