The Worldwide Registry on the Management of Helicobacter Pylori Infection (WorldHpReg) is the union of multiple international prospective multicenter registries on the management of Helicobacter pylori infection and its treatment in the clinical practice of gastroenterologists.
WorldHpReg was born in 2021 under the impetus of the European Registry on Helicobacter pylori Management (Hp-EuReg) and currently has the participation of the regions of Latin America, Africa, Australia, Canada, the Association of Southeast Asian Nations, the United States, Pakistan, Saudi Arabia, India, Jordan and New Zealand.
What is the objective of WorldHpReg?
The great diversity of treatment regimens and lines for the eradication of Helicobacter pylori and their different effectiveness, due above all to the increase in bacterial antibiotic resistance and regional differences, requires a continuous critical analysis of clinical practice, systematically evaluating the efficacy and safety of the various regimens and the cost-effectiveness of the different diagnostic-therapeutic strategies.
A Global Registry on the management of H. pylori can help design effective and optimized treatments that reduce the number of retreatments, diagnostic tests and the appearance of associated pathologies such as peptic ulcers and gastric cancers. Therefore, the evaluation of real clinical practice through non-interventional registries can help to improve the design and organization of a Consensus on the management of H. pylori infection in each territory.
Generally, there is a delay from the publication of the recommendations until their implementation in routine clinical practice, sometimes reaching full penetration after they have become obsolete. It is essential to carry out prospective studies, in real life, that allow us to create tools capable of providing data to evaluate the practice and trends of the results initially obtained at a local, regional and global level.
The main objective of WorldHpReg is to obtain a database that systematically records a large and representative sample of the usual clinical practice of gastroenterologists in each territory to produce descriptive studies on the management of H pylori infection. With the epidemiological data obtained, better therapeutic strategies can be designed according to the evidence, the available drugs and the accessibility to health technologies of each reality.
HP-LATAMReg (@hplatamreg)
The Hp-LATAMReg is the registry of the practice of Latin American gastroenterologists in the management of Helicobacter pylori infection and its treatment.
The Hp-LATAMReg is an initiative of the Chilean Society of Gastroenterology and the Pan American Organization of Gastroenterology (OPGE).
The Latin American registry is growing day by day, as of April 24, 2023 it had 2,497 patients.
List of managers, centers and countries registered in the Hp-LATAMReg until the time of publication.
MEXICO
• Remes-Troche, Jose Maria. Veracruzana University, Veracruz, Mexico.
• González Huezo, Maria Saraí. Social Security Institute of the State of Mexico and Municipalities, Toluca, Mexico.
• Bosques Padilla, Francisco Javier. Tecnológico de Monterrey, Monterrey, Nuevo León, Mexico.
• Coss Adame, Enrique. Salvador Zubirán National Institute of Medical Sciences and Nutrition, Mexico City, Mexico.
• Velarde Ruiz Velasco, José Antonio. Guadalajara Civil Hospital, Guadalajara, Jalisco, Mexico.
• La Tijera Fig Tree, Fátima. General Hospital of Mexico Dr. Eduardo Liceaga, Mexico City, Mexico City, Mexico.
• Raña-Garibay, Ricardo. Spanish Hospital of Mexico, Mexico City, Mexico.
• Flores Rendon, Ricardo. Baja California Institute of Security and Social Services of Government Workers and Municipalities of the State of Baja California, Tijuana, Mexico.
• Gómez-Escudero, Octavio. Angeles Puebla Hospital, Puebla, Mexico.
• Yamamoto Furusho, Jesus. Medical Sur Hospital, Mexico City, Mexico.
• Valdes, Eumir Israel Juárez. Hospital Juárez de México, Mexico City, Mexico.
• Ortiz-Olvera, Nayeli X. UMAE CMN Sigle XXI IMSS, Mexico City, Mexico.
PERU
• Piscoya-Rivera, Alejandro. Guillermo Kaelin de la Fuente Hospital, Lima, Peru.
• Ramírez García, Juan. Liga Contra el Cancer Clinic, Lima, Peru.
• Cedrón-Cheng, Hugo Guillermo. Anglo American Clinic, Lima, Peru.
• Cabrera Hinojosa, Dacio Héctor. Dos de Mayo National Hospital, Lima, Peru.
• Otoya, Guillermo. Guillermo Almenara Irigoyen Hospital, Lima, Peru.
CHILI
• Riquelme, Arnoldo. Reyes-Placencia, Diego. Vargas, César. Medel-Jara, Patricio. Latorre, Gonzalo. Chahuán, Javier. Pizarro, Margarita. Binder, María Victoria. Bustamante, Miguel. Dukes, Eitan. Martínez, Francisca. Silva, Felipe. Candia, Roberto. Vargas Domínguez, José Ignacio. Gastroenterology, Pontifical Catholic University of Chile, Santiago, Chile.
• Von Muhlenbrock, Christian. Universidad de los Andes Clinic, Las Condes, Sant Metropolitan Region, Chile.
• Arenas, Alex. Clínica Alemana de Santiago SA, Vitacura, Metropolitan Region, Chile.
• Mansilla Vivar, Rodrigo. Puerto Montt Hospital, Puerto Montt, Llanquihue, Chile.
ARGENTINA
• Laudanno, Oscar. Doctor Alfredo Lanari Institute, Buenos Aires, Argentina.
• Ahumaran, Gabriel. Monte Grande Clinic, Buenos Aires, Argentina.
• Rodríguez, Pablo César. Córdoba Model Institute, Córdoba, Argentina.
• Bedini, Oscar Alfredo. Digestive Endoscopy Center, Rosario, Argentina.
• Ustares, Fernando. Lavalle Sanatorium, Jujuy, Argentina.
COLOMBIA
• Otero, William. Marulanda, Hernando. National University of Colombia, Bogotá, Colombia.
• Otero, Lina. Otero, Elder. Gastroenterology and Endoscopy Center, Bogotá, Colombia.
• Trespalacios, Alba. Pontifical Javeriana University, Bogotá, Colombia.
COSTA RICA
• Campos Nuñez, Christian. Hospital Clínica Biblica, San José, Costa Rica.
ECUADOR
• Hanna-Jairala, Ignacio. Miguel H Alcívar Hospital, Guayaquil, Guayas, Ecuador.
SPAIN
• Gisbert, Javier P., Nyssen, Olga P., Parra, Pablo. La Princesa University Hospital, Madrid, Spain.
• Cano-Català, Anna. GOES research group, Althaia, Xarxa Assistencial Universitària de Manresa, Manresa. Institute for Research and Innovation in Life and Health Sciences of Central Catalonia (IRIS-CC), Vic, Spain.
• Moreira, Leticia. Hospital Clínic de Barcelona, Barcelona, Catalunya, Spain.
The Hp-LATAMReg is an open registry for all those who wish to participate in the different countries of Latin America.
If you want to know the requirements, you must contact Dr. Diego Reyes-Plasencia (dmreyes@uc.cl).
Hp-LATAMReg PRODUCT PUBLICATIONS UNTIL MAY 2024.
1. First description of the data from the Latin American Registry on the management of Helicobacter pylori infection (Hp-LATAMReg).
Presented at the European Helicobacter and Microbiota Study Group during the 36th International Workshop on Helicobacter & Microbiota in Inflammation & Cancer. Antwerp, Beligium. Set. 2023.
Objective: There is limited information regarding the best approach for Helicobacter pylori management in Latin America. Our aim was to describe the main characteristics of the H. pylori eradication treatment in Latin America.
Materials and Methods: A multicenter, prospective, international registry (Hp-LATAMReg) was conducted. Information about therapies used by gastroenterologists in five countries (Chile, Argentina, Mexico, Peru, and Colombia) from 2015 to 2023 was registered in an e-CRF AEG-REDCap database. The modified intention-to-treat (mITT) effectiveness, safety, and adherence was analyzed for the first-line regimens. Data were quality reviewed.
Results: We registered 681 patients, of which 599 (88%) were treatment-naïve. The most frequent indication for treatment was dyspepsia (n=443, 65%). The most commonly prescribed first-line therapies were: proton pump inhibitor (PPI)-amoxicillin (A)-clarithromycin (C), PPI-C-A-Metronidazole (M), PPI-A, PPI-C-A-Bismuth (B) and PPI -A-Levofloxacin (L). Most of the regimens were 14-day long (n=546.93%), and administered low-dose PPIs (n=282, 47%). The first-line mITT overall effectiveness ranged from 80% to 91%, and PPI+C+A+M was the only regimen that achieved over 90% eradication (Table). The incidence of at least one adverse event was 35%, the most common being abdominal pain (17%).
Acceptable adherence, defined as >90% of drug intake, was observed in 97%.
Conclusions: In Latin America, optimal (>90%) effectiveness was only obtained with 14-day concomitant non-bismuth quadruple therapy (PPI-C-A-M). Triple therapies and low-dose PPIs are still commonly prescribed, leaving room for improvement.
2. Helicobacter pylori diagnostic tests and indications of treatment from the Latin American registry on the management of Helicobacter pylori infection (Hp-LATAMReg)
Presented for the Pan American Gastroenterology Week. Chile 2023.
Published in the Journal of Gastroenterology of Peru. Abstract S95.
DOI: https://doi.org/10.47892/rgp.2023.43Supl1.1616
Background: There is limited information regarding the best approach for Helicobacter pylori (H.pylori) management in Latin America.
Objectives: Describes the H. pylori diagnostic tests and indications of treatment in Latin America.
Methods: A multicenter, retrospective, international registry (Hp-LATAMReg) was conducted. Information about therapies used by gastroenterologists in six countries (Argentina, Chile, Colombia, Costa Rica, Mexico, and Peru) from 2015 to 2023 was registered in an e-CRF AEG-REDCap database. The most frequent indications for treatment and diagnostic tests before and after eradication treatment were described.
Results: 1,378 patients were registered, of which 933 (68%) were female. The mean (SD) age of the patients was 53 (14) years. 524 patients (38%) were from Mexico, 210 patients (15%) from Argentina, 210 (15%) from Chile, 200 (14%) from Colombia, 176 (13%) from Peru and 58 (4.2%) from Costa Delicious. 1218 (89%) were treatment naïve. The most frequent indication for treatment were non-investigated dyspepsia (n=526, 38%) and dyspepsia with normal endoscopy (n=334, 24%). The main H. pylori diagnostic methods before the eradication treatment were: histology (n=905, 67%), rapid urease test (RUT) (n=196, 14%) and 13C urea breath test (UBT) (n=180, 13%). To assess post-treatment eradication, the most frequent H. pylori diagnostics test used were: stool antigen (SA) monoclonal test (n=530, 39%), 13C UBT (n=400, 29%) and 14C UBT (n= 215, 16%). There were statistical differences between the countries regarding the indication for treatment and the diagnostics methods before and after the eradication therapy (Table 1).
Conclusions: In Latin America, there was marked heterogeneity between the countries regarding the main indications of treatment and the most frequently used diagnostics tests for H. pylori infection. It is necessary a consensus on the management of H. pylori infection in Latin America.
3. Abstract presented for UEGW 2024.
Background: Helicobacter pylori infection is a public health problem in Latin America. The aim was to describe the main Helicobacter pylori eradication therapies, their eradication rates, adherence, side effects, proton pump inhibitor (PPI) potency and length of treatment.
Methods: A multicenter, prospective, international registry (Hp-LATAMReg) was conducted. Information about therapies used by gastroenterologists in seven countries (Argentina, Chile, Colombia, Costa Rica, Ecuador, Mexico, and Peru) from 2015 to 2024 was registered in an e-CRF AEG-REDCap database. The modified intention-to-treat (mITT) effectiveness, safety, and adherence was analyzed for the first-line regimens. The length of the treatment and the proton pump inhibitor (PPI) dose were analyzed too.
+Results: 2,511 patients were registered, of which 2,323 (93%) were treatment-naïve. The most commonly prescribed first-line therapies (n=2,163, 86%) were analyzed: standard clarithromycin-based triple therapy (SCTT) (PPI-amoxicillin (A)-clarithromycin (C); n=771, 29%), PPI -C-A-Metronidazole (M) (n=362, 14%), dual therapy (DT) (PPI-A; n=274, 11%), PPI-M-Doxycycline (D)-B (n=198,7.9 %), PPI-M-Tetracycline (Tc)-Bismuth (B) (n=184, 7.3%), PPI-A-M-B (n=156,6.2%), PPI-C-A-B (n=113, 4.5%), and PPI-A-Levofloxacin (L) (n=105, 4.2%).
The first-line mITT overall effectiveness ranged from 73% to 95%, with the PPI-A-M-B and PPI-C-A-M being the only therapies which had an eradication rate of more than 90%. The DT had the lowest rate of side effects with a 7.3% (n=20).
The highest rate of side effects was from the PPI-M-D-B (48%, n=95). Good adherence, defined as >90% of drug intake, was observed in 85% (n=2,124), most of the regimens were 14-day long (n=2,028, 81%) and administered high-dose PPIs (54 to 128 mg omeprazole equivalents b.i.d.) (n=1,355, 54%) with differences between the schemes in those characteristics (p<0.01) (Table 1).
Conclusions: In Latin America, quadruple therapies were the only therapies which had an effectiveness above 90%. DT had the lowest side effects rate with an acceptable eradication rate. SCTT had an unacceptable eradication rate and a high side effects rate but was still the therapy most frequently used in Latin America.
Table 1. Eradication rate, side effects rate, acceptable adherence rates, high PPI potency and length of the treatment of the different schemes. *Chi square test. mITT = modified intention to treat; SCTT = Standard clarithromycin-based triple therapy; DT = Dual therapy; PPI = Proton pump inhibitor; C = Clarithromycin; A = Amoxicillin; B = Bismuth salts; M = Metronidazole; L = Levofloxacin; T = Tetracycline; D = Doxycycline.
4. Posters presented at DDW Washington 2024
Registrations for the Pan American Week of Digestive Diseases (SPED) 2025 are now open!
From August 28 to 31, 2025, the city of Lima, Peru will be the meeting point for the most outstanding professionals in gastroenterology from all over the continent, becoming the epicenter of knowledge and innovation, with a top-level scientific program that will include:
– Renowned national and international speakers.
– Updates on the main topics of gastroenterology.
– Plenary sessions, symposia and keynote lectures.
This is the most important event of the next year in the field of digestive diseases, and we want you to be part of it!
REGISTER HERE
UEG in Spanish: Webinar Practical tips and tricks for performing a quality endoscopy for the general Gastroenterologist
November 7, 2024
18:30 – 19:30 CET Vienna (Austria) & Madrid (Spain)
11:30 Mexico City (Mexico)|
12:30 Lima (Peru)
14:30 Santiago (Chile), Buenos Aires (Argentina) & Rio de Janeiro
Registration:
https://my.ueg.eu/applications/1400
Expert speakers:
Moderator:
Ignacio Catalan-Serra, Norway
Co-coordinators:
María Pellisé, Spain (AEG President)
Alejandro Piscoya, Peru (OPGE President)
Learning objectives:
• Practical tips on how to perform a good quality gastroscopy and colonoscopy
• Learn how to perform a basic ERCP and how to overcome technical difficulties
• Practical examples on how to diagnose and treat basic pathology in your daily endoscopy practice
We extend a cordial invitation to those who attend the UEG WEEK at the Messe Wien congress center
In the Strauss 2 hall starting at 10am (Vienna time, GMT+2)
The Symposium coordinator will be Dr. Piscoya, president of OPGE. And the speaker will be Dr. Smecuol with the topic “Recent contributions in the clinical management and treatment of celiac disease from Latin America.”
Gastro Endo Córdoba 2024. “An educational and innovative experience”
September 12-14, 2024
Córdoba Convention Center
More Information and Program CLICK HERE
We highlight the participation of doctors Alejandro Piscoya and Hugo Cedrón as representatives of OPGE in the III Regional Course on Gastroenterology and Advanced Endoscopy in the city of Manta, Ecuador.
Live virtual broadcast https://cursoregionaldegastroenterologia2024.com/evento.php
This August 8, 9 and 10, the “III Regional Course on Gastroenterology and Advanced Endoscopy” is being held in the Cities of Portoviejo and Manta, which will be broadcast from the Madre Teresa Specialized Hospital – IECED Manabí, with the “Live Cases” ” to Hotel Manta-Host; where the Teachers will show their experiences, skill and knowledge in the management of each of them.
This event is sponsored by: OPGE, SIED, SOCENDI, SEG-MANABÍ, IECED, and with the endorsement of the PUCEM, this academic activity has medical update topics. The director of the course, Dr. Carlos Robles expresses his gratitude to the Scientific Societies that endorse the event, to the medical equipment and drug companies for the support received; Hoping to have the participation of doctors from the country and visitors from abroad, let us also remember that it is transmitted virtually to other countries in the world.
OPGE will be participating in the XXVIII Peruvian Congress of Digestive Diseases with Doctors Riquelme and Otero
Save the days! We invite you from August 28 to 31 at the Swisshotel to the XXVIII Peruvian Congress of Digestive Diseases, with great national and international speakers. To register and see the full program visit: https://socgastro.org.pe/gastrolima-2024/
II REGIONAL COURSE OF ADVANCED GASTROENTEROLOGY AND ENDOSCOPY
The course is aimed at doctors specializing in pediatrics, gastroenterology; endoscopy, digestive surgery, metabolism and related specialties; It will take place on Thursday the 8th, Friday the 9th and Saturday the 10th of August.
2024.
The transmission of live cases of Advanced Endoscopic Interventionism will be carried out from our Hospital to the Headquarters Hotel in the city of Manta, and on this occasion the following courses will be held:
– Training Course in Basic Gastroenterology for Residents in Gastroenterology, Emergencies, Internal Medicine, Geriatrics, Family Medicine and related specialties.
– Update Course in Pediatric Gastroenterology.
– High Specialty Course in Nutrition and Metabolism.
OPGE will be present with presentations by Dr. Alejandro Piscoya (PER), Dr. Hugo Cedrón (PER) and Dr. Luis Caro (ARG).
The course is hybrid. The virtual modality has a pre-registration of attendees that must be completed by July 25, 2024; using the following access link:
https://www.cursoregionaldegastroenterologia2024.com/
MASLD online course Comprehensive management of hepatic steatosis: Diagnosis, treatment and future perspectives
GENERAL OBJECTIVE
– Provide learning tools to doctors specializing in gastroenterology to approach MASLD patients in daily practice.
– Update on the diagnosis and treatment of the disease.
SPECIFIC OBJECTIVES
– Update knowledge on the pathophysiology of MASLD: Provide a detailed understanding of the biological mechanisms and risk factors associated with the development and progression of MASLD.
– Improve diagnostic skills: Train healthcare professionals in the use of modern diagnostic tools, including imaging methods and non-invasive markers, for the identification and assessment of the severity of MASLD.
– Review and discuss therapeutic options: Analyze available treatment strategies, both pharmacological and non-pharmacological, and discuss current recommendations for the comprehensive management of MASLD.
– Facilitate the exchange of knowledge and experiences: Create a space for interaction and debate between specialists, facilitating the exchange of experiences and best practices in the management of MASLD.
– MORE INFORMATION AND REGISTRATION
Assembly of Presidents of the Pan American Gastroenterology Organization within the framework of the Digestive Disease Week held in Washington, 2024
On Sunday, May 19, the Assembly of Presidents of the OPGE took place in room 12 of the Marriot Marquis Washington Hotel.
The session was developed by Dr. Alejandro Piscoya, Dr. Edgardo Smecuol and Dr. Hugo Cedrón, and included the participation of the presidents of the different countries that make up the OPGE.
During the meeting, important agreements were reached:
· Formation of the Committee to create the OPGE Joven regulations, an initiative to support and encourage the development of gastroenterologists under 40 years of age.
· The design of the flyer for the Pan American Week of Digestive Diseases (SPED) to be held in the city of Lima from August 28 to 31, 2025 is presented.
· The development of On-line Courses sponsored by OPGE will be resumed.
The OPGE supports the Latin American Registry of Helicobacter pylori (HP-Latam Reg)
The Worldwide Registry on the Management of Helicobacter Pylori Infection (WorldHpReg) is the union of multiple international prospective multicenter registries on the management of Helicobacter pylori infection and its treatment in the clinical practice of gastroenterologists.
WorldHpReg was born in 2021 under the impetus of the European Registry on Helicobacter pylori Management (Hp-EuReg) and currently has the participation of the regions of Latin America, Africa, Australia, Canada, the Association of Southeast Asian Nations, the United States, Pakistan, Saudi Arabia, India, Jordan and New Zealand.
What is the objective of WorldHpReg?
The great diversity of treatment regimens and lines for the eradication of Helicobacter pylori and their different effectiveness, due above all to the increase in bacterial antibiotic resistance and regional differences, requires a continuous critical analysis of clinical practice, systematically evaluating the efficacy and safety of the various regimens and the cost-effectiveness of the different diagnostic-therapeutic strategies.
A Global Registry on the management of H. pylori can help design effective and optimized treatments that reduce the number of retreatments, diagnostic tests and the appearance of associated pathologies such as peptic ulcers and gastric cancers. Therefore, the evaluation of real clinical practice through non-interventional registries can help to improve the design and organization of a Consensus on the management of H. pylori infection in each territory.
Generally, there is a delay from the publication of the recommendations until their implementation in routine clinical practice, sometimes reaching full penetration after they have become obsolete. It is essential to carry out prospective studies, in real life, that allow us to create tools capable of providing data to evaluate the practice and trends of the results initially obtained at a local, regional and global level.
The main objective of WorldHpReg is to obtain a database that systematically records a large and representative sample of the usual clinical practice of gastroenterologists in each territory to produce descriptive studies on the management of H pylori infection. With the epidemiological data obtained, better therapeutic strategies can be designed according to the evidence, the available drugs and the accessibility to health technologies of each reality.
HP-LATAMReg (@hplatamreg)
The Hp-LATAMReg is the registry of the practice of Latin American gastroenterologists in the management of Helicobacter pylori infection and its treatment.
The Hp-LATAMReg is an initiative of the Chilean Society of Gastroenterology and the Pan American Organization of Gastroenterology (OPGE).
The Latin American registry is growing day by day, as of April 24, 2023 it had 2,497 patients.
List of managers, centers and countries registered in the Hp-LATAMReg until the time of publication.
MEXICO
• Remes-Troche, Jose Maria. Veracruzana University, Veracruz, Mexico.
• González Huezo, Maria Saraí. Social Security Institute of the State of Mexico and Municipalities, Toluca, Mexico.
• Bosques Padilla, Francisco Javier. Tecnológico de Monterrey, Monterrey, Nuevo León, Mexico.
• Coss Adame, Enrique. Salvador Zubirán National Institute of Medical Sciences and Nutrition, Mexico City, Mexico.
• Velarde Ruiz Velasco, José Antonio. Guadalajara Civil Hospital, Guadalajara, Jalisco, Mexico.
• La Tijera Fig Tree, Fátima. General Hospital of Mexico Dr. Eduardo Liceaga, Mexico City, Mexico City, Mexico.
• Raña-Garibay, Ricardo. Spanish Hospital of Mexico, Mexico City, Mexico.
• Flores Rendon, Ricardo. Baja California Institute of Security and Social Services of Government Workers and Municipalities of the State of Baja California, Tijuana, Mexico.
• Gómez-Escudero, Octavio. Angeles Puebla Hospital, Puebla, Mexico.
• Yamamoto Furusho, Jesus. Medical Sur Hospital, Mexico City, Mexico.
• Valdes, Eumir Israel Juárez. Hospital Juárez de México, Mexico City, Mexico.
• Ortiz-Olvera, Nayeli X. UMAE CMN Sigle XXI IMSS, Mexico City, Mexico.
PERU
• Piscoya-Rivera, Alejandro. Guillermo Kaelin de la Fuente Hospital, Lima, Peru.
• Ramírez García, Juan. Liga Contra el Cancer Clinic, Lima, Peru.
• Cedrón-Cheng, Hugo Guillermo. Anglo American Clinic, Lima, Peru.
• Cabrera Hinojosa, Dacio Héctor. Dos de Mayo National Hospital, Lima, Peru.
• Otoya, Guillermo. Guillermo Almenara Irigoyen Hospital, Lima, Peru.
CHILI
• Riquelme, Arnoldo. Reyes-Placencia, Diego. Vargas, César. Medel-Jara, Patricio. Latorre, Gonzalo. Chahuán, Javier. Pizarro, Margarita. Binder, María Victoria. Bustamante, Miguel. Dukes, Eitan. Martínez, Francisca. Silva, Felipe. Candia, Roberto. Vargas Domínguez, José Ignacio. Gastroenterology, Pontifical Catholic University of Chile, Santiago, Chile.
• Von Muhlenbrock, Christian. Universidad de los Andes Clinic, Las Condes, Sant Metropolitan Region, Chile.
• Arenas, Alex. Clínica Alemana de Santiago SA, Vitacura, Metropolitan Region, Chile.
• Mansilla Vivar, Rodrigo. Puerto Montt Hospital, Puerto Montt, Llanquihue, Chile.
ARGENTINA
• Laudanno, Oscar. Doctor Alfredo Lanari Institute, Buenos Aires, Argentina.
• Ahumaran, Gabriel. Monte Grande Clinic, Buenos Aires, Argentina.
• Rodríguez, Pablo César. Córdoba Model Institute, Córdoba, Argentina.
• Bedini, Oscar Alfredo. Digestive Endoscopy Center, Rosario, Argentina.
• Ustares, Fernando. Lavalle Sanatorium, Jujuy, Argentina.
COLOMBIA
• Otero, William. Marulanda, Hernando. National University of Colombia, Bogotá, Colombia.
• Otero, Lina. Otero, Elder. Gastroenterology and Endoscopy Center, Bogotá, Colombia.
• Trespalacios, Alba. Pontifical Javeriana University, Bogotá, Colombia.
COSTA RICA
• Campos Nuñez, Christian. Hospital Clínica Biblica, San José, Costa Rica.
ECUADOR
• Hanna-Jairala, Ignacio. Miguel H Alcívar Hospital, Guayaquil, Guayas, Ecuador.
SPAIN
• Gisbert, Javier P., Nyssen, Olga P., Parra, Pablo. La Princesa University Hospital, Madrid, Spain.
• Cano-Català, Anna. GOES research group, Althaia, Xarxa Assistencial Universitària de Manresa, Manresa. Institute for Research and Innovation in Life and Health Sciences of Central Catalonia (IRIS-CC), Vic, Spain.
• Moreira, Leticia. Hospital Clínic de Barcelona, Barcelona, Catalunya, Spain.
The Hp-LATAMReg is an open registry for all those who wish to participate in the different countries of Latin America.
If you want to know the requirements, you must contact Dr. Diego Reyes-Plasencia (dmreyes@uc.cl).
Hp-LATAMReg PRODUCT PUBLICATIONS UNTIL MAY 2024.
1. First description of the data from the Latin American Registry on the management of Helicobacter pylori infection (Hp-LATAMReg).
Presented at the European Helicobacter and Microbiota Study Group during the 36th International Workshop on Helicobacter & Microbiota in Inflammation & Cancer. Antwerp, Beligium. Set. 2023.
Objective: There is limited information regarding the best approach for Helicobacter pylori management in Latin America. Our aim was to describe the main characteristics of the H. pylori eradication treatment in Latin America.
Materials and Methods: A multicenter, prospective, international registry (Hp-LATAMReg) was conducted. Information about therapies used by gastroenterologists in five countries (Chile, Argentina, Mexico, Peru, and Colombia) from 2015 to 2023 was registered in an e-CRF AEG-REDCap database. The modified intention-to-treat (mITT) effectiveness, safety, and adherence was analyzed for the first-line regimens. Data were quality reviewed.
Results: We registered 681 patients, of which 599 (88%) were treatment-naïve. The most frequent indication for treatment was dyspepsia (n=443, 65%). The most commonly prescribed first-line therapies were: proton pump inhibitor (PPI)-amoxicillin (A)-clarithromycin (C), PPI-C-A-Metronidazole (M), PPI-A, PPI-C-A-Bismuth (B) and PPI -A-Levofloxacin (L). Most of the regimens were 14-day long (n=546.93%), and administered low-dose PPIs (n=282, 47%). The first-line mITT overall effectiveness ranged from 80% to 91%, and PPI+C+A+M was the only regimen that achieved over 90% eradication (Table). The incidence of at least one adverse event was 35%, the most common being abdominal pain (17%).
Acceptable adherence, defined as >90% of drug intake, was observed in 97%.
Conclusions: In Latin America, optimal (>90%) effectiveness was only obtained with 14-day concomitant non-bismuth quadruple therapy (PPI-C-A-M). Triple therapies and low-dose PPIs are still commonly prescribed, leaving room for improvement.
2. Helicobacter pylori diagnostic tests and indications of treatment from the Latin American registry on the management of Helicobacter pylori infection (Hp-LATAMReg)
Presented for the Pan American Gastroenterology Week. Chile 2023.
Published in the Journal of Gastroenterology of Peru. Abstract S95.
DOI: https://doi.org/10.47892/rgp.2023.43Supl1.1616
Background: There is limited information regarding the best approach for Helicobacter pylori (H.pylori) management in Latin America.
Objectives: Describes the H. pylori diagnostic tests and indications of treatment in Latin America.
Methods: A multicenter, retrospective, international registry (Hp-LATAMReg) was conducted. Information about therapies used by gastroenterologists in six countries (Argentina, Chile, Colombia, Costa Rica, Mexico, and Peru) from 2015 to 2023 was registered in an e-CRF AEG-REDCap database. The most frequent indications for treatment and diagnostic tests before and after eradication treatment were described.
Results: 1,378 patients were registered, of which 933 (68%) were female. The mean (SD) age of the patients was 53 (14) years. 524 patients (38%) were from Mexico, 210 patients (15%) from Argentina, 210 (15%) from Chile, 200 (14%) from Colombia, 176 (13%) from Peru and 58 (4.2%) from Costa Delicious. 1218 (89%) were treatment naïve. The most frequent indication for treatment were non-investigated dyspepsia (n=526, 38%) and dyspepsia with normal endoscopy (n=334, 24%). The main H. pylori diagnostic methods before the eradication treatment were: histology (n=905, 67%), rapid urease test (RUT) (n=196, 14%) and 13C urea breath test (UBT) (n=180, 13%). To assess post-treatment eradication, the most frequent H. pylori diagnostics test used were: stool antigen (SA) monoclonal test (n=530, 39%), 13C UBT (n=400, 29%) and 14C UBT (n= 215, 16%). There were statistical differences between the countries regarding the indication for treatment and the diagnostics methods before and after the eradication therapy (Table 1).
Conclusions: In Latin America, there was marked heterogeneity between the countries regarding the main indications of treatment and the most frequently used diagnostics tests for H. pylori infection. It is necessary a consensus on the management of H. pylori infection in Latin America.
3. Abstract presented for UEGW 2024.
Background: Helicobacter pylori infection is a public health problem in Latin America. The aim was to describe the main Helicobacter pylori eradication therapies, their eradication rates, adherence, side effects, proton pump inhibitor (PPI) potency and length of treatment.
Methods: A multicenter, prospective, international registry (Hp-LATAMReg) was conducted. Information about therapies used by gastroenterologists in seven countries (Argentina, Chile, Colombia, Costa Rica, Ecuador, Mexico, and Peru) from 2015 to 2024 was registered in an e-CRF AEG-REDCap database. The modified intention-to-treat (mITT) effectiveness, safety, and adherence was analyzed for the first-line regimens. The length of the treatment and the proton pump inhibitor (PPI) dose were analyzed too.
+Results: 2,511 patients were registered, of which 2,323 (93%) were treatment-naïve. The most commonly prescribed first-line therapies (n=2,163, 86%) were analyzed: standard clarithromycin-based triple therapy (SCTT) (PPI-amoxicillin (A)-clarithromycin (C); n=771, 29%), PPI -C-A-Metronidazole (M) (n=362, 14%), dual therapy (DT) (PPI-A; n=274, 11%), PPI-M-Doxycycline (D)-B (n=198,7.9 %), PPI-M-Tetracycline (Tc)-Bismuth (B) (n=184, 7.3%), PPI-A-M-B (n=156,6.2%), PPI-C-A-B (n=113, 4.5%), and PPI-A-Levofloxacin (L) (n=105, 4.2%).
The first-line mITT overall effectiveness ranged from 73% to 95%, with the PPI-A-M-B and PPI-C-A-M being the only therapies which had an eradication rate of more than 90%. The DT had the lowest rate of side effects with a 7.3% (n=20).
The highest rate of side effects was from the PPI-M-D-B (48%, n=95). Good adherence, defined as >90% of drug intake, was observed in 85% (n=2,124), most of the regimens were 14-day long (n=2,028, 81%) and administered high-dose PPIs (54 to 128 mg omeprazole equivalents b.i.d.) (n=1,355, 54%) with differences between the schemes in those characteristics (p<0.01) (Table 1).
Conclusions: In Latin America, quadruple therapies were the only therapies which had an effectiveness above 90%. DT had the lowest side effects rate with an acceptable eradication rate. SCTT had an unacceptable eradication rate and a high side effects rate but was still the therapy most frequently used in Latin America.
Table 1. Eradication rate, side effects rate, acceptable adherence rates, high PPI potency and length of the treatment of the different schemes. *Chi square test. mITT = modified intention to treat; SCTT = Standard clarithromycin-based triple therapy; DT = Dual therapy; PPI = Proton pump inhibitor; C = Clarithromycin; A = Amoxicillin; B = Bismuth salts; M = Metronidazole; L = Levofloxacin; T = Tetracycline; D = Doxycycline.
4. Posters presented at DDW Washington 2024