Effectiveness and Safety of First-Line Empirical Eradication Therapy with Rebamipide: Results from the European Registry on Helicobacter pylori Management (Hp-EuReg)

Bordin, Dmitry S.; Andreev, Dmitrii N.; Abdulkhakov, Sayar R.; Voynovan, Irina N.; Bakulin, Igor G.; Bakulina, Natalia V.; Vologzhanina, Ludmila G.; Starostin, Boris D.; Sarsenbayeva, Aiman S.; Ilchishina, Tatyana A.; Tarasova, Larisa V.; Kononova, Alla G.; Alekseenko, Sergey A.; Zaytsev, Oleg V.; Dekhnich, Natalya N.; Bogomolov, Pavel O.; Tarasova, Galina N.; Kolokolnikova, Olga A.; Khlynov, Igor B.; Plotnikova, Ekaterina Yu.; Baryshnikova, Natalia V.; Livzan, Maria A.; Osipenko, Marina F.; Bakanova, Natalya V.; Partsvania-Vinogradova, Ekaterina V.; Chebotareva, Margarita V.; Abdulkhakov, Rustam A.; Savilova, Inna V.; Sushilova, Anastasia G.; Kolbasnikov, Sergey V.; Khurmatullina, Alsu R.; Maev, Igor V.; Tishchenko, Maria O.; Petrova, Rimma E.; Morkovkina, Ludmila V.; Tsyganova, Yulia V.; Kozlova, Мargarita D.; Iakovlev, Aleksei A.; Volkov, Alexander S.; Moroz, Elizaveta S.; Gaus, Olga V.; Alba, Singla; Farrés, Oriol; Moreira, Leticia; Parra, Pablo; Nyssen, Olga P.; Megraud, Francis; O’Morain, Colm; Gisbert, Javier P.

doi:10.3390/antibiotics15060531

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Open AccessArticle

Effectiveness and Safety of First-Line Empirical Eradication Therapy with Rebamipide: Results from the European Registry on Helicobacter pylori Management (Hp-EuReg)

by

Dmitry S. Bordin

^1,2,3,*

,

Dmitrii N. Andreev

²

,

Sayar R. Abdulkhakov

^4,5

,

Irina N. Voynovan

¹

,

Igor G. Bakulin

⁶,

Natalia V. Bakulina

⁶,

Ludmila G. Vologzhanina

⁷,

Boris D. Starostin

⁸

,

Aiman S. Sarsenbayeva

⁹,

Tatyana A. Ilchishina

¹⁰

,

Larisa V. Tarasova

¹¹,

Alla G. Kononova

³,

Sergey A. Alekseenko

¹²,

Oleg V. Zaytsev

¹³,

Natalya N. Dekhnich

¹⁴,

Pavel O. Bogomolov

^2,15,16,17,

Galina N. Tarasova

¹⁸,

Olga A. Kolokolnikova

¹⁹,

Igor B. Khlynov

²⁰,

Ekaterina Yu. Plotnikova

²¹,

Natalia V. Baryshnikova

^22,23

,

Maria A. Livzan

²⁴

,

Marina F. Osipenko

²⁵,

Natalya V. Bakanova

²⁶

,

Ekaterina V. Partsvania-Vinogradova

²,

Margarita V. Chebotareva

¹,

Rustam A. Abdulkhakov

⁵,

Inna V. Savilova

⁶,

Anastasia G. Sushilova

⁶,

Sergey V. Kolbasnikov

³,

Alsu R. Khurmatullina

^2,27

,

Igor V. Maev

²,

Maria O. Tishchenko

⁸,

Rimma E. Petrova

⁸,

Ludmila V. Morkovkina

¹¹,

Yulia V. Tsyganova

¹¹,

Мargarita D. Kozlova

¹⁴,

Aleksei A. Iakovlev

¹⁸,

Alexander S. Volkov

¹⁸,

Elizaveta S. Moroz

¹⁹,

Olga V. Gaus

²⁴

,

Singla Alba

²⁸,

Oriol Farrés

²⁸,

Leticia Moreira

²⁹

,

Pablo Parra

³⁰

,

Olga P. Nyssen

³⁰

,

Francis Megraud

³¹,

Colm O’Morain

³²

and

Javier P. Gisbert

³⁰ Show full author list Hide full author list

¹

Department of Pancreatic, Biliary Tract and Upper Digestive Tract Disorders, A.S. Loginov Moscow Clinical Scientific Center, 111123 Moscow, Russia

²

Department of Propaedeutics of Internal Diseases and Gastroenterology, Faculty of Medicine, Russian University of Medicine, 127473 Moscow, Russia

³

Department of Outpatient Therapy and Family Medicine, Tver State Medical University, 170100 Tver, Russia

⁴

Department of Internal Medicine, Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia

⁵

Department of Hospital Therapy, Faculty of Medicine, Kazan State Medical University, 420012 Kazan, Russia

⁶

Department of Propaedeutics of Internal Diseases, Gastroenterology and Dietetics Named After S.M. Ryss; Department of Internal Medicine, Clinical Pharmacology and Nephrology, I.I. Mechnikov North-Western State Medical University, 191015 Saint Petersburg, Russia

⁷

Department of Faculty Therapy No. 1, Perm State Medical University Named after Academician E.A. Wagner, 614990 Perm, Russia

⁸

Interdistrict Gastroenterological Center No. 1, City Polyclinic No. 38, 191015 Saint Petersburg, Russia

⁹

Department of Therapy, Institute of Additional Professional Education, South Ural State Medical University, 454092 Chelyabinsk, Russia

¹⁰

Medical Holding “SM-Clinic” (Medi Com LLC), 194355 Saint Petersburg, Russia

¹¹

Department of Hospital Therapy, I.N. Ulyanov Chuvash State University, 428015 Cheboksary, Russia

¹²

Department of Hospital Therapy, Far Eastern State Medical University, 680000 Khabarovsk, Russia

¹³

First Clinical Medical Centre, 601900 Kovrov, Russia

¹⁴

Department of Faculty Therapy, Smolensk State Medical University, 214019 Smolensk, Russia

¹⁵

Private Medical Center “Universal” LLC, 109382 Moscow, Russia

¹⁶

Hepatology Department, M.F. Vladimirsky Moscow Regional Clinical Research Institute, 129110 Moscow, Russia

¹⁷

Targeted Therapy Center LLC, 125008 Moscow, Russia

¹⁸

Department of Internal Diseases Propaedeutics, Rostov State Medical University, 344022 Rostov-on-Don, Russia

¹⁹

Department of Gastroenterology and Genetically Engineered Biological Therapy, MEDSI Clinical Hospital No. 1 in Otradnoye, 143442 Moscow Region, Russia

²⁰

Department of Faculty Therapy and Geriatrics, Ural State Medical University, 620028 Yekaterinburg, Russia

²¹

Department of Outpatient Therapy, Postgraduate Education and Nursing Care, Kemerovo State Medical University, 650029 Kemerovo, Russia

²²

Department of Internal Diseases, Saint Petersburg State Pediatric Medical University, 194100 Saint Petersburg, Russia

²³

Department of Molecular Microbiology, Institute of Experimental Medicine, 197376 Saint Petersburg, Russia

²⁴

Department of Faculty Therapy and Gastroenterology, Omsk State Medical University, 644099 Omsk, Russia

²⁵

Department of Propaedeutics of Internal Diseases, Novosibirsk State Medical University, 630091 Novosibirsk, Russia

²⁶

Gastroenterology Service, Medical Center “Medicea”, 426000 Izhevsk, Russia

²⁷

N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia

²⁸

Gastrointestinal Oncology, Endoscopy and Surgery (GOES) Research Group, Althaia Xarxa Assistencial Universitària de Manresa, Institut de Recerca i Innovació en Ciències de la Vida i de la Salut a la Catalunya Central (IRIS-CC), 08243 Manresa, Spain

²⁹

Gastroenterology Service, Institute of Digestive and Metabolic Diseases (ICMDM), Hospital Clínic de Barcelona, CIBEREHD, IDIBAPS, University of Barcelona, 08036 Barcelona, Spain

³⁰

Department of Gastroenterology, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), CIBEREHD, 28006 Madrid, Spain

³¹

Inserm U1312, BRIC, Université de Bordeaux, 33076 Bordeaux, France

³²

School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland

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^*

Author to whom correspondence should be addressed.

Antibiotics 2026, 15(6), 531; https://doi.org/10.3390/antibiotics15060531 (registering DOI)

Submission received: 15 April 2026 / Revised: 14 May 2026 / Accepted: 20 May 2026 / Published: 23 May 2026

(This article belongs to the Section Antibiotic Therapy in Infectious Diseases)

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Abstract

Background/Objective: Eradication of Helicobacter pylori typically uses acid-suppressing agents plus antimicrobials, but treatment failure may reach 20–30%. Adjunctive rebamipide has been proposed as a strategy to improve treatment outcomes. This study aimed to assess the effectiveness and safety of first-line empirical therapy when rebamipide was added to eradication regimens. Methods: Treatment-naïve patient data were collected between January 2020 and August 2024 from the European Registry on Helicobacter pylori Management (Hp-EuReg), an international, prospective, multicentre, observational study. Rebamipide-containing regimens were analysed and compared with those without rebamipide. Effectiveness was assessed using a modified intention-to-treat approach. Results: Overall, 4581 patients (mean age 48 ± 15 years, 64% women) from 15 Russian cities were included. From those, 820 patients received eradication therapy with rebamipide and 3761 without rebamipide. Overall effectiveness was significantly higher with rebamipide (731/763, 96%) than without it (2785/3059, 91%) (p = 0.0002). Rebamipide-containing triple therapy consisting of a proton-pump inhibitor (PPI), clarithromycin and amoxicillin was associated with effectiveness above 90%, while rebamipide-containing quadruple therapy consisting of a PPI, clarithromycin, amoxicillin and bismuth yielded a 97% eradication rate, compared with 79% and 95%, respectively, without rebamipide (p < 0.001). Adverse events were significantly more frequent in patients receiving rebamipide-containing regimens (46% vs. 29%, p < 0.0001), though none were serious or caused discontinuation. Compliance was similar in both groups (99% vs. 98.5%; p > 0.05). Conclusions: In this observational registry cohort, first-line empirical triple therapy with amoxicillin–clarithromycin, and quadruple therapy with amoxicillin–clarithromycin–bismuth, both prescribed with rebamipide, were associated with higher eradication rates than regimens without rebamipide.

Keywords: Helicobacter pylori; eradication; antimicrobial therapy; rebamipide; treatment; registry

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MDPI and ACS Style

Bordin, D.S.; Andreev, D.N.; Abdulkhakov, S.R.; Voynovan, I.N.; Bakulin, I.G.; Bakulina, N.V.; Vologzhanina, L.G.; Starostin, B.D.; Sarsenbayeva, A.S.; Ilchishina, T.A.; et al. Effectiveness and Safety of First-Line Empirical Eradication Therapy with Rebamipide: Results from the European Registry on Helicobacter pylori Management (Hp-EuReg). Antibiotics 2026, 15, 531. https://doi.org/10.3390/antibiotics15060531

AMA Style

Bordin DS, Andreev DN, Abdulkhakov SR, Voynovan IN, Bakulin IG, Bakulina NV, Vologzhanina LG, Starostin BD, Sarsenbayeva AS, Ilchishina TA, et al. Effectiveness and Safety of First-Line Empirical Eradication Therapy with Rebamipide: Results from the European Registry on Helicobacter pylori Management (Hp-EuReg). Antibiotics. 2026; 15(6):531. https://doi.org/10.3390/antibiotics15060531

Chicago/Turabian Style

Bordin, Dmitry S., Dmitrii N. Andreev, Sayar R. Abdulkhakov, Irina N. Voynovan, Igor G. Bakulin, Natalia V. Bakulina, Ludmila G. Vologzhanina, Boris D. Starostin, Aiman S. Sarsenbayeva, Tatyana A. Ilchishina, and et al. 2026. "Effectiveness and Safety of First-Line Empirical Eradication Therapy with Rebamipide: Results from the European Registry on Helicobacter pylori Management (Hp-EuReg)" Antibiotics 15, no. 6: 531. https://doi.org/10.3390/antibiotics15060531

APA Style

Bordin, D. S., Andreev, D. N., Abdulkhakov, S. R., Voynovan, I. N., Bakulin, I. G., Bakulina, N. V., Vologzhanina, L. G., Starostin, B. D., Sarsenbayeva, A. S., Ilchishina, T. A., Tarasova, L. V., Kononova, A. G., Alekseenko, S. A., Zaytsev, O. V., Dekhnich, N. N., Bogomolov, P. O., Tarasova, G. N., Kolokolnikova, O. A., Khlynov, I. B., ... Gisbert, J. P. (2026). Effectiveness and Safety of First-Line Empirical Eradication Therapy with Rebamipide: Results from the European Registry on Helicobacter pylori Management (Hp-EuReg). Antibiotics, 15(6), 531. https://doi.org/10.3390/antibiotics15060531

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Effectiveness and Safety of First-Line Empirical Eradication Therapy with Rebamipide: Results from the European Registry on Helicobacter pylori Management (Hp-EuReg)

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