UEG Week Virtual 2020 Congress Review - 6

UEG Week Congress Review

Scientific Programme Highlights
H. pylori treatment in
Europe evolves over
time with improved
outcomes
European gastroenterological practice
in the treatment of Helicobacter
pylori (H. pylori) has evolved over
time in-line with the latest evidence
and recommendations, achieving
improved overall eradication rates
during the last 7 years. The latest
data from the European Registry in
H. pylori management (Hp-EuReg)
suggests that, between 2013 and
2020, there has been a shifting away
from triple therapies, an increase
in the duration of treatment, and
an increase in the dose of PPIs
prescribed, leading to an overall 5%
improvement in eradication rates for
first-line therapy.

Lifestyle and environment factors determine the
health of the gut microbiome
A healthy gut microbiota signature is determined primarily by lifestyle
and environmental factors, say scientists from the Dutch Microbiome
Project. In their most recent analysis, project scientists have correlated
the metagenomic profiles of stool samples from >8,000 individuals
with >240 phenotypic traits and found that microbiome variation
is significantly explained by health and diseases, and that different
diseases from unrelated disease groups share similar microbiome
patterns.
According to Ranko Gacesa from the University Medical Center Groningen in the
Netherlands, who presented the latest study results, the microbiome associated with
diseases was characterised by significant increases in the prevalence and abundance
of opportunistic pathogens (e.g. Clostridia, Escherichia coli) and oral microbes (e.g.
Ruminococus gnavus, Bifidobacterium dentium, and Streptococcus), while a healthy
microbiome showed high abundances of butyrate-producing bacteria (e.g. Roseburia
hominis, Faecalibacerium prausnitzii) and commensals associated with immune tolerance
(e.g. Bacteroides).
Phenotypic traits found to be positively associated with a healthier microbiome included
a healthy diet, a childhood spent in a rural area, green space, and having pets. Disease-like
signatures were attributed to the use of medications such as proton pump inhibitors (PPIs),
antidiabetics and antibiotics; a high-carbohydrate diet, glycaemic load, and calorie intake;
parental smoking; and living with environmental pollution. Genetics was found to explain
only a minor part of the variance between health- and disease-associated microbiota, with
only 31/421 taxa (13% of the microbiome) significantly heritable.

6

The study presented by Olga Nyssen
from the University Hospital La
Princesa in Madrid, Spain, included
28,194 patients from 29 European
countries and 24,882 first-line
empirical prescriptions for the
treatment of H. pylori infection.
Overall, the most commonly
prescribed treatments in 2013-2020
were triple therapies, however,
the proportion of these therapies
decreased from over 50% of
prescriptions in 2013/2015 to
<20% in 2018/2020. Concomitant
therapy also decreased from 21% in
2013/14 to 13% in 2019/2020, while
Pylera® (bismuth, metronidazole,
tetracycline) prescriptions increased
from 0-1% in 2014/2015 to 18%
in 2018/2020. An increase in the
average duration of treatment from
10.9 days in 2013 to 12.0 in 2020 and
an increase in the dose of PPI used
from a mean omeprazole equivalent
of 58 mg/day in 2013 to 75 mg/
day in 2018 was also observed. In
terms of treatment effectiveness, no
trends were reported for individual
treatments, however, the eradication
rate (modified intention-to-treat)
increased from 85.3% in 2013 to
91.3% in 2020.



UEG Week Virtual 2020 Congress Review

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