Supplementary Material for: Current Status of <b><i>Helicobacter pylori</i></b> Diagnosis and Eradication Therapy in Japan Using a Nationwide Database

<b><i>Background:</i></b> <i>Helicobacter pylori</i> infection increases the risk of stomach cancer; therefore, eradication therapy is recommended for infected individuals. Although several methods are recommended for the diagnosis and therapy of <i>H. pylori</i> infection, their frequency and effectiveness have not been fully investigated in Japan. <b><i>Methods:</i></b> A nationwide claims database including &gt;1.6 million patients (April 2008 – ­October 2016) in Japan was utilized. We analyzed the distribution of methods for <i>H. pylori</i> diagnosis and therapy, waiting period between eradication and diagnostic test, and success rate of primary therapy. <b><i>Results:</i></b> Data for 481,041 patients were extracted. After primary eradication therapy, urea breath test was used for &gt;80% of diagnoses, and antibody measurement for 0.7%. The success rate of primary eradication was &gt;80% for most diagnostic methods and 69.0% for antibody measurement; inappropriately-timed antibody measurement may have contributed to this disparity. The overall success rate of eradication therapy decreased from 2011 to 2014, but increased from 2015, coinciding with launch of the potassium-competitive acid blocker vonoprazan, which showed a higher success rate of eradication than proton-pump inhibitors. <b><i>Conclusions:</i></b> Diagnostic tests of <i>H. pylori</i> infection mostly followed Japanese Society for <i>Helicobacter</i> Research guidance, although some antibody measurements were timed inappropriately. Vonoprazan appears to increase the success rate of primary therapy.**背景：** 幽门螺杆菌（Helicobacter pylori）感染会增加胃癌的发病风险，因此推荐对感染者实施根除治疗。尽管目前已有多种幽门螺杆菌感染的诊断与治疗方案可供选择，但日本地区相关诊疗方法的使用频率与实际疗效尚未得到充分研究。 **方法：** 本研究使用了日本一项覆盖2008年4月至2016年10月、包含超160万例患者的全国性医疗索赔数据库。我们分析了幽门螺杆菌感染诊断与治疗的方法分布、根除治疗与诊断检测之间的等待时长，以及初次治疗的成功率。 **结果：** 本研究最终纳入481041例患者的数据分析。初次根除治疗后，超过80%的患者采用尿素呼气试验（urea breath test）进行感染检测，仅0.7%的患者采用抗体检测。多数诊断方法对应的初次根除治疗成功率超过80%，而抗体检测的成功率仅为69.0%，检测时机不当可能是导致这一差异的原因。2011年至2014年间，根除治疗的整体成功率呈下降趋势，但2015年起有所回升，这与钾竞争性酸阻滞剂（potassium-competitive acid blocker）沃诺拉赞（vonoprazan）的上市时间相符——沃诺拉赞的根除治疗成功率高于质子泵抑制剂（proton-pump inhibitors）。 **结论：** 尽管部分抗体检测存在时机不当的问题，但幽门螺杆菌感染的诊断检测整体符合日本幽门螺杆菌研究学会（Japanese Society for Helicobacter Research）的诊疗指南。沃诺拉赞可有效提升幽门螺杆菌初次根除治疗的成功率。

搜集汇总

背景与挑战

背景概述

该数据集是日本全国范围内关于幽门螺杆菌诊断和根除治疗的补充材料，基于2008年至2016年超过160万患者的索赔数据库，分析了诊断方法分布、治疗等待时间和成功率。结果显示尿素呼气测试是主要诊断方法，根除治疗成功率随时间变化，与vonoprazan药物推出相关，突出现实医疗实践中的诊断和治疗模式。