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Korean Registry on the Current Management of Helicobacter pylori (K-Hp-Reg): Interim Analysis of Adherence to the
Hyo-Joon Yang1, Joon Sung Kim2, Ji Yong Ahn3
1Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Insights
Korean physicians increasingly follow 2020 Helicobacter pylori treatment guidelines. Adherence to these guidelines significantly improves first-line eradication success rates, with 14-day clarithromycin triple therapy and tailored therapy becoming preferred options.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Clinical Practice Guidelines
Background:
- The 2020 revision of Korean guidelines for Helicobacter pylori treatment aimed to optimize eradication strategies.
- Assessing adherence to these updated guidelines in real-world clinical settings is crucial for evaluating their impact.
Purpose of the Study:
- To evaluate the adherence to the revised 2020 Korean guidelines for H. pylori treatment.
- To determine the impact of guideline adherence on first-line H. pylori eradication rates.
- To identify trends in H. pylori treatment regimens prescribed by Korean physicians.
Main Methods:
- A prospective, nationwide, multicenter registry study was conducted in 2021.
- Data collected via a web-based electronic case report form included patient demographics, diagnoses, treatments, and eradication outcomes.
- Statistical analysis, including multivariate logistic regression, was used to assess guideline adherence and eradication success.
Main Results:
- 80.4% of 7,261 patients received first-line treatment adhering to the revised guidelines.
- The overall modified intention-to-treat eradication rate was 81.0%.
- 14-day clarithromycin-based triple therapy (CTT), tailored therapy (TT), and 10-day concomitant therapy (CT) were the most frequently used guideline-adherent regimens, showing increasing trends.
Conclusions:
- Increasing adoption of the revised H. pylori treatment guidelines in Korea is associated with improved first-line eradication rates.
- 14-day CTT, 10-day CT, and TT are emerging as preferred first-line treatment options in Korean clinical practice.
- Guideline adherence demonstrated a significant positive association with successful first-line H. pylori eradication.
Background/Aims:
The Korean guidelines for Helicobacter pylori treatment were revised in 2020, however, the extent of adherence to these guidelines in clinical practice remains unclear. Herein, we initiated a prospective, nationwide, multicenter registry study in 2021 to evaluate the current management of H. pylori infection in Korea.
Methods:
This interim report describes the adherence to the revised guidelines and their impact on first-line eradication rates. Data on patient demographics, diagnoses, treatments, and eradication outcomes were collected using a web-based electronic case report form.
Results:
A total of 7,261 patients from 66 hospitals who received first-line treatment were analyzed. The modified intention-to-treat eradication rate for first-line treatment was 81.0%, with 80.4% of the prescriptions adhering to the revised guidelines. The most commonly prescribed regimen was the 14-day clarithromycin-based triple therapy (CTT; 42.0%), followed by tailored therapy (TT; 21.2%), 7-day CTT (14.1%), and 10-day concomitant therapy (CT; 10.1%). Time-trend analysis demonstrated significant increases in guideline adherence and the use of 10-day CT and TT, along with a decrease in the use of 7-day CTT (all p<0.001). Multivariate logistic regression analysis revealed that guideline adherence was significantly associated with first-line eradication success (odds ratio, 2.03; 95% confidence interval, 1.61 to 2.56; p<0.001).
Conclusions:
The revised guidelines for the treatment of H. pylori infection have been increasingly adopted in routine clinical practice in Korea, which may have contributed to improved first-line eradication rates. Notably, the 14-day CTT, 10-day CT, and TT regimens are emerging as the preferred first-line treatment options among Korean physicians.
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