Table 2.
First- and second-line H. pylori treatment effectiveness in the younger and older European populations.
| Treatment | Younger adults (18–59 years) | Older adults (≥ 60 years) | ||||||
|---|---|---|---|---|---|---|---|---|
| Use, N | PP % (95% CI) | mITT % (95% CI) | ITT % (95% CI) | Use, N | PP % (95% CI) | mITT % (95% CI) | ITT % (95% CI) | |
| Effectiveness of first-line treatment prescriptions between the younger and older populations | ||||||||
| Triple PPI + C + A | 10,540 | 87 (86–87) | 86 (85–87)* | 67 (66–68)* | 4065 | 88 (87–89) | 87 (86–89)* | 71 (69–72)* |
| Triple PPI + C + M | 1150 | 86 (84–88) | 86 (83–88) | 68 (65–71) | 491 | 83 (79–86) | 83 (79–86) | 71 (66–75) |
| Triple PPI + A + L | 425 | 83 (79–87) | 83 (78–86) | 76 (72–80) | 162 | 83 (75–88) | 83 (76–89) | 76 (69–82) |
| Quadruple PPI + C + A + M | 4199 | 90 (89–91)* | 89 (88–90)* | 86 (85–87)* | 1940 | 91 (90–93)* | 91 (90–92)* | 89 (87–90)* |
| Quadruple PPI + C + A + B | 3489 | 92 (91–93) | 92 (91–93) | 76 (75–77) | 1086 | 91 (89–93) | 90 (88–92) | 76 (73–79) |
| Quadruple PPI + C + A + T | 309 | 98 (95–99) | 96 (93–98) | 92 (88–95) | 127 | 96 (89–99) | 92 (85–96) | 86 (78–92) |
| Pylera® (single capsule)1 | 3233 | 94 (93–95) | 93 (92–94) | 89 (87–90) | 1519 | 94 (93–95) | 93 (92–95) | 89 (87–91) |
| Sequential C + A + T | 1291 | 90 (88–92)* | 90 (88–91)* | 80 (78–82)* | 623 | 94 (92–96)* | 94 (91–96)* | 85 (81–87)* |
| Sequential C + A + M | 458 | 84 (80–87) | 82 (78–86) | 76 (72–80) | 222 | 84 (78–89) | 82 (76–87) | 75 (69–81) |
| Effectiveness of second-line treatment prescriptions between the younger and older populations | ||||||||
| Triple PPI + A + L | 1422 | 83 (80–85) | 82 (80–84) | 74 (71–76) | 524 | 80 (76–84) | 80 (76–83) | 73 (69–77) |
| Triple PPI + C + A | 323 | 78 (72–83) | 78 (72–83) | 60 (54–65) | 102 | 84 (74–91) | 84 (74–91) | 68 (58–77) |
| Triple PPI + A + R | 105 | 80 (70–87) | 79 (69–87) | 68 (58–76) | 49 | 82 (67–92) | 82 (67–92) | 74 (59–85) |
| Triple PPI + A + Mx | 105 | 92 (85–97) | 92 (85–97) | 90 (82–95) | 35 | 87 (70–96) | 87 (70–96) | 77 (60–90) |
| Quadruple PPI + A + L + B | 584 | 89 (86–92) | 89 (86–91) | 73 (69–76) | 225 | 86 (80–91) | 86 (80–91) | 75 (69–81) |
| Quadruple PPI + C + A + M | 234 | 84 (79–89) | 84 (78–88) | 80 (74–85) | 91 | 86 (77–92) | 86 (77–93) | 83 (73–90) |
| Quadruple PPI + M + Tc + B | 224 | 86 (80–91) | 84 (78–88) | 75 (69–81) | 101 | 87 (78–93) | 88 (79–94) | 77 (68–85) |
| Quadruple PPI + C + A + B | 229 | 91 (85–96)* | 91 (85–95)* | 52 (45–59) | 66 | 79 (64–89)* | 80 (66–90)* | 60 (47–72) |
| Pylera® (single capsule)1 | 843 | 89 (87–91) | 89 (86–91) | 83 (80–86)* | 384 | 92 (89–95) | 91 (88–94) | 88 (84–91)* |
PP—per protocol, mITT—modified Intention-To-Treat, ITT—Intention-To-Treat, 95% CI—95% confidence interval, PPI—proton pump inhibitor, C—clarithromycin, A—amoxicillin, M—metronidazole, B—bismuth, T—tinidazole, L—levofloxacin, Tc—tetracycline, Mx—moxifloxacin, R—rifabutin.
1Pylera®: three-in-one single-capsule containing metronidazole, tetracycline and bismuth.
*Statistically significant differences between the age groups, p < 0.05.