Efficacy and Safety of Helicobacter pylori Eradication in the Elderly: A Propensity Score Matching Analysis
10.3969/j.issn.1008-7125.2022.04.002
- Author:
Nayun SU
1
;
Ling FAN
1
;
Hao MEI
1
;
Jie HU
1
;
Yuxiang LIU
1
;
Chunhui LAN
1
Author Information
1. Department of Gastroenterology, Chongqing Key Laboratory of Digestive Malignancies, Daping Hospital, Army Medical University (Third Military Medical University)
- Publication Type:Journal Article
- Keywords:
Aged;
Antibiotic Resistance;
Compliance;
Eradication Treatment;
Helicobacter pylori;
Safety
- From:
Chinese Journal of Gastroenterology
2022;27(4):225-231
- CountryChina
- Language:Chinese
-
Abstract:
Background: The benefits and risks of eradicating Helicobacter pylori (Hp) should be balanced in aged people. Aims: To investigate the efficacy, safety and antibiotic resistance status of Hp eradication treatment in the elderly. Methods: Four cohorts of subjects who received Hp eradication treatment in randomized controlled trials conducted in Chongqing Daping Hospital were reviewed; the demographic and clinical data were extracted and recorded. Propensity score matching was performed to select comparable elderly group (≥60 years old) and non-elderly group (<60 years old). The eradication rate, compliance, adverse events, antibiotic resistance, and the influencing factors of eradication were analyzed in these two groups. Results: A total of 994 subjects receiving Hp eradication treatment were enrolled initially, among them, 224 were categorized as elderly group and non-elderly group by propensity score matching, with 122 subjects in each group. The Hp eradication rates were higher than 90% in both elderly and non-elderly groups, and no significant differences were observed in compliance, drug-related adverse events, and antibiotic resistance rates between these two groups (all P>0.05). Furthermore, there were no significant differences in the Hp eradication rates in terms of gender, cigarette smoking, alcohol consumption, comorbidities (hypertension, diabetes, surgical history, and inflammation), compliance, etc. in the elderly group (all P> 0.05). But in retreated elderly subjects, the resistance rate of clarithromycin was higher than that in naïve elderly subjects (P<0.05). Smoking and poor compliance were identified as independent risk factors for Hp eradication by multivariate Logistic regression analysis. Conclusions: Hp eradication in the elderly demonstrates comparable efficacy and safety with non-elderly subjects. Clarithromycin-containing regimens are not recommended for empirical retreatment in aged people.
