@AmCollegeGastro @umfoodoc @EBGIdoc @AGA_Gastro @LorenLaine2 @AasmaShaukatMD @AmitPatelDukeMD @YaleDigestive @IUGastro @ShimaghavimiMD @TennysonMD @shifaumarMD 2/📜Importance?
🚫lansoprazole triple tx + Clarithromycin(C) -> ~30% eradication in C-resistant🦠
⚠️% C resistance > 20% in 🇺🇸
✅Bismuth-based quadruple tx (BQT) + rifabutin(R)-based triple tx ->preferred.
🛑 BQT:⬇️Compliance+💊burden; R-based tx: ⬆️💵, lack of awareness.
🚫lansoprazole triple tx + Clarithromycin(C) -> ~30% eradication in C-resistant🦠
⚠️% C resistance > 20% in 🇺🇸
✅Bismuth-based quadruple tx (BQT) + rifabutin(R)-based triple tx ->preferred.
🛑 BQT:⬇️Compliance+💊burden; R-based tx: ⬆️💵, lack of awareness.
@AmCollegeGastro @umfoodoc @EBGIdoc @AGA_Gastro @LorenLaine2 @AasmaShaukatMD @AmitPatelDukeMD @YaleDigestive @IUGastro @ShimaghavimiMD @TennysonMD @shifaumarMD 3/ Vonaprazan🧐 (V)
📍 K-competitive acid 🚫
📍 Produce early & more potent acid suppression than conventional PPIs 🟰 more successful tx of H. pylori.
📍Gastric acid 🚫-> ⬆️ activity of Amox + C & ⬇️
active bacterial replication of H. pylori
gi.org #EBGI
📍 K-competitive acid 🚫
📍 Produce early & more potent acid suppression than conventional PPIs 🟰 more successful tx of H. pylori.
📍Gastric acid 🚫-> ⬆️ activity of Amox + C & ⬇️
active bacterial replication of H. pylori
gi.org #EBGI
@AmCollegeGastro @umfoodoc @EBGIdoc @AGA_Gastro @LorenLaine2 @AasmaShaukatMD @AmitPatelDukeMD @YaleDigestive @IUGastro @ShimaghavimiMD @TennysonMD @shifaumarMD @Badr_AlBawardy @gastrodocmattar @IBD_Houston @DaniaHudhud @alhaddad_mo 4/🔎Design:
💡Phase 3, multicenter, double-blind RCT
💡Pts from 103 sites in the 🇺🇸, 🇬🇧, 🇧🇬, 🇨🇿, 🇭🇺and 🇵🇱
💡 🥇endpoint : H. pylori eradication based on Neg 13C-urea breath test obtained at least 4wks after the last dose of study 💊
💡Phase 3, multicenter, double-blind RCT
💡Pts from 103 sites in the 🇺🇸, 🇬🇧, 🇧🇬, 🇨🇿, 🇭🇺and 🇵🇱
💡 🥇endpoint : H. pylori eradication based on Neg 13C-urea breath test obtained at least 4wks after the last dose of study 💊
@AmCollegeGastro @umfoodoc @EBGIdoc @AGA_Gastro @LorenLaine2 @AasmaShaukatMD @AmitPatelDukeMD @YaleDigestive @IUGastro @ShimaghavimiMD @TennysonMD @shifaumarMD @Badr_AlBawardy @gastrodocmattar @IBD_Houston @DaniaHudhud @alhaddad_mo @IBDimmunology @ibdgijami @EmoryGastroHep @AnthonyLemboMD @Tabibian_MDPhD @doctornikkid 5/Study population
🔦992 were fully evaluated
🔦Mean age: 51-52 years old
🔦37% 👨🦰
🔦90% ⚪️
🔦42% from 🇺🇸
🔦98% with dyspepsia as an indication to test for H. pylori
🔦20% with Clarithromycin-R strains
🔦1% with Amoxicillin-R strains
🔦63% with Metronidazole-Resistant strains
🔦992 were fully evaluated
🔦Mean age: 51-52 years old
🔦37% 👨🦰
🔦90% ⚪️
🔦42% from 🇺🇸
🔦98% with dyspepsia as an indication to test for H. pylori
🔦20% with Clarithromycin-R strains
🔦1% with Amoxicillin-R strains
🔦63% with Metronidazole-Resistant strains
@AmCollegeGastro @umfoodoc @EBGIdoc @AGA_Gastro @LorenLaine2 @AasmaShaukatMD @AmitPatelDukeMD @YaleDigestive @IUGastro @ShimaghavimiMD @TennysonMD @shifaumarMD @Badr_AlBawardy @gastrodocmattar @IBD_Houston @DaniaHudhud @alhaddad_mo @IBDimmunology @ibdgijami @EmoryGastroHep @AnthonyLemboMD @Tabibian_MDPhD @doctornikkid @drmoutaz @JBrandlerMD @StonyBrookGI @UMichGIHep @KU_GIHep @GeorgetownGI @UNMC_GIHEP @DannyIssaMD @AmyOxentenkoMD 6/🗝️Study Findings
🗝️V-dual tx and V-triple tx were superior to lansoprazole-triple tx for🦠eradication
Result same in
🥇all pts (77.2% vs 80.8% vs 68.5%, respectively, P < 0.01)
➕
🥈pts w/ C-R strains (69.6% vs 65.8% vs 31.9%, respectively, P < 0.001)
🗝️V-dual tx and V-triple tx were superior to lansoprazole-triple tx for🦠eradication
Result same in
🥇all pts (77.2% vs 80.8% vs 68.5%, respectively, P < 0.01)
➕
🥈pts w/ C-R strains (69.6% vs 65.8% vs 31.9%, respectively, P < 0.001)
@AmCollegeGastro @umfoodoc @EBGIdoc @AGA_Gastro @LorenLaine2 @AasmaShaukatMD @AmitPatelDukeMD @YaleDigestive @IUGastro @ShimaghavimiMD @TennysonMD @shifaumarMD @Badr_AlBawardy @gastrodocmattar @IBD_Houston @DaniaHudhud @alhaddad_mo @IBDimmunology @ibdgijami @EmoryGastroHep @AnthonyLemboMD @Tabibian_MDPhD @doctornikkid @drmoutaz @JBrandlerMD @StonyBrookGI @UMichGIHep @KU_GIHep @GeorgetownGI @UNMC_GIHEP @DannyIssaMD @AmyOxentenkoMD @wabillin @ellebelle18 @DrAnatapia @MehwishAhmedMD @MikeKattahMD @KM_Pawlak @MN_GIMD @MonteGastro 7/⚠️Caution:
💢Since only treatment-naïve H. pylori patients were enrolled--> study doesn’t provide data about the management of pts with REFRACTORY H. pylori 🦠
💢Since only treatment-naïve H. pylori patients were enrolled--> study doesn’t provide data about the management of pts with REFRACTORY H. pylori 🦠
@AmCollegeGastro @umfoodoc @EBGIdoc @AGA_Gastro @LorenLaine2 @AasmaShaukatMD @AmitPatelDukeMD @YaleDigestive @IUGastro @ShimaghavimiMD @TennysonMD @shifaumarMD @Badr_AlBawardy @gastrodocmattar @IBD_Houston @DaniaHudhud @alhaddad_mo @IBDimmunology @ibdgijami @EmoryGastroHep @AnthonyLemboMD @Tabibian_MDPhD @doctornikkid @drmoutaz @JBrandlerMD @StonyBrookGI @UMichGIHep @KU_GIHep @GeorgetownGI @UNMC_GIHEP @DannyIssaMD @AmyOxentenkoMD @wabillin @ellebelle18 @DrAnatapia @MehwishAhmedMD @MikeKattahMD @KM_Pawlak @MN_GIMD @MonteGastro 8/ Dr. Schoenfeld's #MyPractice #EBGI
❗️@ VA:🥇tx is bismuth quad tx
⚠️limited by formulary -> rifabutin triple tx as salvage tx in ref🦠
🗝️V dual tx w/ Amox would be🥇if💵+availability concerns are fixed
🔦@ACG recs: routinely 🧐 post-tx test of cure:💩 antigen is preferred
❗️@ VA:🥇tx is bismuth quad tx
⚠️limited by formulary -> rifabutin triple tx as salvage tx in ref🦠
🗝️V dual tx w/ Amox would be🥇if💵+availability concerns are fixed
🔦@ACG recs: routinely 🧐 post-tx test of cure:💩 antigen is preferred
@AmCollegeGastro @umfoodoc @EBGIdoc @AGA_Gastro @LorenLaine2 @AasmaShaukatMD @AmitPatelDukeMD @YaleDigestive @IUGastro @ShimaghavimiMD @TennysonMD @shifaumarMD @Badr_AlBawardy @gastrodocmattar @IBD_Houston @DaniaHudhud @alhaddad_mo @IBDimmunology @ibdgijami @EmoryGastroHep @AnthonyLemboMD @Tabibian_MDPhD @doctornikkid @drmoutaz @JBrandlerMD @StonyBrookGI @UMichGIHep @KU_GIHep @GeorgetownGI @UNMC_GIHEP @DannyIssaMD @AmyOxentenkoMD @wabillin @ellebelle18 @DrAnatapia @MehwishAhmedMD @MikeKattahMD @KM_Pawlak @MN_GIMD @MonteGastro @acg @MayoClinicGIHep @UTSWGI @IrisWangMD @GiClinicalFocus @gutdoc18 9/Future studies :
💡Assess real-🌍 efficacy of V-based tx in pts w/ refractory H. pylori🦠
💡 Use next-generation sequencing or other tools to better define rates of💊-R strains in # parts of🇺🇸
💡QI: assess interventions 2 improve the frequency of eradication testing
💡Assess real-🌍 efficacy of V-based tx in pts w/ refractory H. pylori🦠
💡 Use next-generation sequencing or other tools to better define rates of💊-R strains in # parts of🇺🇸
💡QI: assess interventions 2 improve the frequency of eradication testing
@AmCollegeGastro @umfoodoc @EBGIdoc @AGA_Gastro @LorenLaine2 @AasmaShaukatMD @AmitPatelDukeMD @YaleDigestive @IUGastro @ShimaghavimiMD @TennysonMD @shifaumarMD @Badr_AlBawardy @gastrodocmattar @IBD_Houston @DaniaHudhud @alhaddad_mo @IBDimmunology @ibdgijami @EmoryGastroHep @AnthonyLemboMD @Tabibian_MDPhD @doctornikkid @drmoutaz @JBrandlerMD @StonyBrookGI @UMichGIHep @KU_GIHep @GeorgetownGI @UNMC_GIHEP @DannyIssaMD @AmyOxentenkoMD @wabillin @ellebelle18 @DrAnatapia @MehwishAhmedMD @MikeKattahMD @KM_Pawlak @MN_GIMD @MonteGastro @acg @MayoClinicGIHep @UTSWGI @IrisWangMD @GiClinicalFocus @gutdoc18 10/Hope you enjoyed this #EBGI summary, please share your thoughts and comments on how it would impact your clinical practice.
For more summaries, go to gi.org
Suggestions, DM @JosephHabibi_MD
See you next week with ⭐️moderator @LDhaliwalMD
For more summaries, go to gi.org
Suggestions, DM @JosephHabibi_MD
See you next week with ⭐️moderator @LDhaliwalMD
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