THE ROLE OF GENDER, AGE AND MEDICAL ACTIVITIES IN THE EFFECTIVENESS OF HELICOBACTER PYLORI ERADICATION

The aim of the research. Analysis of the results of Helicobacter pylori (H. pylori) treatment with the firstline regimen and bismuth in residents of the Transbaikal region depending on gender, age and medical activity.
Materials and methods. H. pylori eradication was performed using a first-line regimen (proton pump inhibitor, clarithromycin, amoxicillin) and bismuth tripotassium dicitrate at recommended doses for 14 days in 116 people. Of these, 82 were women and 34 were men, 59 were aged 20–50 years and 57 were aged 51– 65 years, 52 were medical staff and 64 were non-medical. Eradication control was performed 6–8 weeks after treatment with H. pylori antigen in feces using immunochromatographic analysis. During treatment, adverse events (AE) were analyzed.
Statistical methods: descriptive statistics, x2-test, odds ratio (OR) (biostatistics). Results. The efficiency of H. pylori eradication in the study group was 71,5%, among medical staff – 57,7%, among non-medical – 82,8% (p = 0,003). More successful treatment was observed among female non-medical (92,1%), in contrast to male non-medical (69,2%, p = 0,018) and female medical staff (52,3%, p < 0,001).
Non-medical aged 20–50 demonstrated the best eradication results – 93,3%, patients aged 51–65 nonmedical – 73,5% (p = 0,037), medical staff aged 20–50 – 58,6% (p = 0,002). There were no gender or age differences in the group of medical staff. AE were registered in 64 people (55,2%): 35 (67,3%) medical staff and 29 (45,3%) non-medical. AE were 2,5 times more common in male medical staff than in men in other specialties (p = 0,009).
Conclusion. Probability of H. pylori eradication is higher in women under 50 years of age who are not medically active. H. pylori eradication is less common in medical staff with-out gender or age differences, with a higher incidence of AE, especially in men.

1. Malfertheiner P., Megraud F., Rokkas Th., et al. Management of Helicobacter pylori infection: the MaastrichtVI/Florence consensus report. Gut. 2022. gutjnl-2022-327745. DOI 10.1136/gutjnl-2022-327745.

2. Lazebnik L.B., Dekhnich N.N., Sitkin S.I., et al. Helicobacter pylori, helicobacteriosis and associated diseases (VIII Moscow Agreements on the diagnosis and treatment of helicobacteriosis in adults and children) A Clinical Guide for Physicians. Eksperimental'naya i klinicheskaya gastroenterologiya. 2024. (12). 49–145. DOI 10.31146/1682-8658-ecg-232-12-49-145. in Russian.

3. Megraud F., Bruyndonckx R., Coenen S., et al. Helicobacter pylori resistance to antibiotics in Europe in 2018 and its relationship to antibiotic consumption in the community. Gut 2021. 70 (10). 1815–1822. DOI 10.1136/gutjnl-2021-324032.

4. Mayev I.V., Andreyev D.N., Bordin D.S. Helicobacter pylori Resistance to Clarithromycin in the Russian Federation. Effektivnaya farmakoterapiya. 2020. 16 (30).16–22. in Russian. DOI 10.33978/2307-3586-2020-16-30-16-22.

5. Bordin D.S., Plavnik R.G., Nevmerzhitskiy V.I., et al. Prevalence of Helicobacter pylori among medical workers in Moscow and Kazan according to ¹³С-urease breath test. Al'manakh klinicheskoy meditsiny. 2018. 46 (1). 40–49. DOI 10.18786/2072-0505-2018-46-1-40-49. in Russian.

6. Mori H., Suzuki H., Omata F. et al. Current status of first- and second-line Helicobacter pylori eradication therapy in the metropolitan area: a multicenter study with a large number of patients. Therap Adv Gastroenterol. 2019. 12. 1756284819858511. DOI 10.1177/1756284819858511.

7. Kukes V.G., Grachev S.V., Sychev D.A., Ramenskaya G.V. Metabolism of drugs. The Scientific Foundations of Personalized Medicine: A Guide for Physicians. M. GEOTAR-Media. 2008. 304 p. in Russian.

8. Ivashkin V.T., Lapina T.L., Maev I.V., et al. Clinical Practice Guidelines of Russian Gastroenterological Association, Scientific Society for the Clinical Study of Human Microbiome, Russian Society for the Prevention of Non-Communicable Diseases, Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy for Н. pylori Diagnostics and Treatment in Adults. Rossijskij zhurnal gastroenterologii, gepatologii, koloproktologii. 2022. 32 (6). 72–93. in Russian. DOI 10.22416/1382-4376-2022-32-6-72-93.

9. Nyssen O.P., Bordin D., Tepes B., et al. European Registry on management (Hp-EuReg): patterns and trends in first-line empirical eradication prescription and outcomes of 5 years and 21 533 patients. Gut. 2021. 70(1). 40-54. DOI 10.1136/gutjnl-2020-321372.

10. Jonaitis P., Nyssen O.P., Saracino I.M., et al. Comparison of the management of Helicobacter pylori infection between the older and younger European populations. Sci Rep. 2023. 1 (1). 17235. DOI 10.1038/s41598-023-43287-4. In Russian.

11. Kusunoki M., Yuki M., Ishitobi H., et al. Effect of Age on Effectiveness of Vonoprazan in Triple Therapy for Helicobacter pylori. Intern Med. 2019. 58 (11). 1549–1555. DOI 10.2169/internalmedicine.2233-18.

12. Tang Y., Tang G., Pan L., et al. Clinical factors associated with initial Helicobacter pylori eradication therapy: a retrospective study in China. Sci. Rep. 2020. 10. 15403. DOI 10.1038/s41598-020-72400-0.

13. Yokota N., Ae R., Amenomori M., et al. Clinical background factors affecting outcomes of Helicobacter pylori eradication therapy in primary care. J Gen Fam Med. 2019. 20 (4). 139-145. DOI 10.1002/jgf2.245.

14. Ma T-L., Tai W-Ch., Loke S-S., et al. Efficacy and Safety of 7-Day Non-Bismuth Concomitant Quadruple Therapy for First-Line Helicobacter pylori Eradication in the Elderly. Drugs Aging. 2023. 40 (1). 71–79. DOI 10.1007/s40266-022-00990-7.

15. Huang T-T., Cao Y-X., Cao L. Novel therapeutic regimens against Helicobacter pylori: an updated systematic review. Front Microbiol. 2024. 15. 1418129. DOI 10.3389/fmicb.2024.1418129.

16. González-Hormazábal P., Arenas A., Serrano C., et al. Prevalence of Helicobacter pylori Antimicrobial Resistance Among Chilean Patients. Arch Med Res. 2021. 52 (5). 529–534. DOI 10.1016/j.arcmed.2021.01.011.

17. Mayev I.V., Mkrtumyan A.M., Bektemirova L.G., Andreyev D.N., Dicheva D.T. The effectiveness of eradication therapy of the 1st line of Helicobacter pylori infection in patients with type 2 diabetes mellitus. Terapevticheskii Arkhiv. 2022. 94 (2). 209–215. In Russian. DOI 10.26442/00403660.2022.2.201372.

18. Qiao Y., Zhou Y., Zhao L., et al. Sex differences in Helicobacter pylori infection and recurrence rate among 81,754 Chinese adults: a cross-sectional study. BMC Gastroenterol. 2024. 24 (1). 305. DOI 10.1186/s12876-024-03404-7.

19. Morilla A.M., Álvarez-Argüelles M.E., Duque J.M., et al. Primary antimicrobial resistance rates and prevalence of Helicobacter pylori infection in the north of Spain. A 13-year retrospective study. Gastroenterol Hepatol. 2019. S0210-5705(19)30129-3. DOI 10.1016/j.gastrohep.2019.05.002. In Russian.

20. Yakusheva E.N., Shchul'kin A.V., Popova N.M., Chernykh I.V., Titov D.S. Structure, functions of P-glycoprotein and its role in rational pharmacotherapy. Obzory po klinicheskoj farmakologii i lekarstvennoj terapii. 2014. 12 (2). 3–11. In Russian.

21. Bakulina N.V., Simanenkov V.I., Bakulin I.G., Ilchishina T.A. Prevalence of helicobacter pylori infection among physicians. Eksperimental'naya i klinicheskaya gastroenterologiya. 2017. 148 (12). 20–24. In Russian.

22. Jonaitis P., Kupcinskas J., Gisbert J.P., Jonaitis L. Helicobacter pylori Eradication Treatment in Older Patients. Drugs Aging. 2024. 41 (2). 141–151. DOI 10.1007/s40266-023-01090-w.

23. Veliev A.M., Maev I.V., Andreev D.N. et al. The efficacy and safety of quadruple therapy without bismuth (concomitant therapy) in the treatment of patients with Helicobacter pylori - associated gastric and duodenal peptic ulcer disease. Terapevticheskii arkhiv. 2019. 91 (8). 28–33. DOI 10.26442/00403660.2019.08.000382. in Russian.