SUMMARY
Background. Gastric lesions associated with Helicobacter pylori, eradication issues and problems of its sometimes-insufficient therapeutical effectiveness continue to remain one of the most pressing topics in digestive healthcare. The aim of the study was to evaluate the frequency of use, the effectiveness and the safety of empirical first-line treatments in the management of H. pylori infection in Azerbaijan. Materials and methods. Data were collected at AEG-REDCap from the European Registry on the management of Helicobacter pylori infection (Hp-EuReg) and quality reviewed from January 2020 to May 2023. All treatment-naïve cases were assessed for effectiveness by modified intention-to-treat (mITT), per-protocol (PP) analyses, and a separate multivariate analysis was performed. Results. The study included 3,898 patients (67% reported dyspepsia). Triple regimens were most often prescribed (82%), the PPI-clarithromycin-amoxicillin scheme being used in 54% of patients. Duration of treatment was of 14 days (56%), 10 days (27%) and 7 days (17%). Optimal (>90%) mITT effectiveness was obtained with following 14-day therapy schemes: PPI-clarithromycin-amoxicillin (94%), PPI-clarithromycin-metronidazole (97%), PPI-clarithromycin-metronidazole-bismuth (96%), and PPI-clarithromycin-amoxicillin-bismuth (98%); when combined with standard-dose PPIs: PPI-amoxicillin-tetracycline (96%) and PPI-clarithromycin-amoxicillin-bismuth (96%); and with high-dose PPIs: PPI-clarithromycin-amoxicillin (94%), PPI-clarithromycin-metronidazole (97%), PPI-clarithromycin-metronidazole-bismuth (100%), and PPI-clarithromycin-amoxicillin-bismuth (99%). Adverse events were reported in 12% of cases. Conclusion. The prescribed H. pylori eradication regimens during the period 2020–2023 in Azerbaijan adhered partially to the Maastricht VI recommendations and were reported highly effective (≥90%), providing a good safety profile.
Keywords: Hp-EuReg, Helicobacter pylori, antisecretory therapy, first-line treatment, bismuth, eradication rate, effectiveness, safety

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