Korean Registry on Helicobacter pylori Management (K-Hp-Reg): Adherence to Korean Guidelines for First-Line Treatment

초록

Background: The Korean guidelines for Helicobacter pylori treatment were revised in 2020; however, the extent of adherence to these guidelines in clinical practice remains unclear. Herein, we initiated a prospective, nationwide, multicenter registry study in 2021 to evaluate the current management of H. pylori infection in Korea. Materials and Methods: This interim report describes the adherence to the revised guidelines and their impact on first-line eradication rates. Data on patient demographics, diagnoses, treatments, and eradication outcomes were collected using a web-based electronic case report form. Results: A total of 7261 patients from 66 hospitals who underwent first-line treatment were analyzed. The modified intention-to-treat eradication rate for first-line treatment was 81.0%, with 80.4% of the prescriptions adhering to the revised guidelines. The most commonly prescribed regimen was the 14-day clarithromycin-based triple therapy (CTT) (42.0%), followed by tailored therapy (TT) (21.2%), 7-day CTT (14.1%), and 10-day concomitant therapy (CT) (10.1%). Time-trend analysis demonstrated significant increases in guideline adherence and the use of 10-day CT and TT, along with a decrease in the use of 7-day CTT (all p < 0.001). Multivariate logistic regression analysis revealed that guideline adherence was significantly associated with first-line eradication success (odds ratio, 2.03; 95% confidence interval, 1.61–2.56; p < 0.001). Conclusions: The revised treatment guidelines for H. pylori infection have been increasingly adopted in routine clinical practice in Korea, which may have contributed to improved first-line eradication rates. Notably, the 14-day CTT, 10-day CT, and TT are emerging as the preferred first-line treatment options among Korean physicians.