ClinicalTrials.gg
RecruitingNCT07821294HED-2TUpdated Oct 27, 2026

Feasibility and Performance of FFPE qPCR for Detection of Clarithromycin Resistance in Helicobacter Pylori

An observational study in HELICOBACTER PYLORI INFECTIONS, sponsored by Clinique Bizet. Recruiting at 1 site in France. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-10-27.

Sponsored by Clinique Bizet · Observational

From the registry’s dates

  • Started Sep 2026; still recruiting 2 months later.
Updated Oct 27, 2026Now RecruitingSite recruiting status changed+1 moreGo to Updates ↓
Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
250
Ages
18 Years and older
Sex
All
01

Study summary

This prospective observational study aims to evaluate the feasibility and performance of real-time PCR (qPCR) performed on formalin-fixed, paraffin-embedded (FFPE) gastric biopsies to detect Helicobacter pylori infection and clarithromycin resistance. The study will assess whether qPCR performed on tissue samples routinely collected for histological examination can reliably identify H. pylori and mutations associated with clarithromycin resistance. Results will be compared with histology, immunohistochemistry, and bacteriological PCR. The study will also assess the potential impact of qPCR results on treatment decisions and the medical-economic impact of this diagnostic strategy.This prospective observational study aims to evaluate the feasibility and performance of real-time PCR (qPCR) performed on formalin-fixed, paraffin-embedded (FFPE) gastric biopsies to detect Helicobacter pylori infection and clarithromycin resistance. The study will assess whether qPCR performed on tissue samples routinely collected for histological examination can reliably identify H. pylori and mutations associated with clarithromycin resistance. Results will be compared with histology, immunohistochemistry, and bacteriological PCR. The study will also assess the potential impact of qPCR results on treatment decisions and the medical-economic impact of this diagnostic strategy.

Read the detailed description

Helicobacter pylori (H. pylori) infection is a common chronic bacterial infection associated with peptic ulcer disease and gastric malignancies. Clarithromycin resistance is an important cause of treatment failure. Current recommendations support susceptibility-guided treatment based on the detection of clarithromycin resistance; however, in routine clinical practice, resistance testing remains infrequently performed.

This prospective, single-center observational study will evaluate the feasibility and diagnostic performance of real-time polymerase chain reaction (qPCR) performed on formalin-fixed, paraffin-embedded (FFPE) gastric biopsies collected during routine gastroscopy. The study will investigate whether FFPE tissue samples already obtained for histopathological examination can be used to detect H. pylori and mutations in the 23S rRNA gene associated with clarithromycin resistance.

Participants will be adults with suspected H. pylori infection who require gastric biopsies during gastroscopy. H. pylori infection will be confirmed by histological examination and immunohistochemistry. For participants with confirmed H. pylori infection, corresponding FFPE tissue blocks will be selected for DNA extraction and qPCR targeting mutations associated with clarithromycin resistance.

The primary objective is to prospectively evaluate the feasibility and performance of qPCR on FFPE gastric biopsies for the detection of clarithromycin resistance in H. pylori in routine clinical practice. Diagnostic performance will include sensitivity and specificity for H. pylori detection and for detection of clarithromycin-resistance mutations, as well as the proportion of samples yielding exploitable results and the time required to obtain results.

Secondary objectives include describing the prevalence and epidemiology of clarithromycin-resistance mutations in the study population; assessing concordance between FFPE qPCR and immunohistochemistry, particularly in cases with low bacterial load; assessing concordance between FFPE qPCR and bacteriological PCR; evaluating the potential impact of qPCR results on therapeutic management; and assessing the medical-economic impact of a clarithromycin-resistance screening strategy based on FFPE qPCR compared with empirical treatment and bacteriological PCR.

The study will include approximately 250 participants. The study is prospective and monocentric and does not involve any modification of the patient's usual clinical management. Gastric biopsies will be collected during routine gastroscopy and analyzed by pathology and bacteriology according to the study protocol. The planned inclusion period is July 2026 to January 2027, with a 10-day follow-up period.

02

Conditions studied

  • HELICOBACTER PYLORI INFECTIONS

Keywords

  • Helicobacter pylori
  • Clarithromycin Resistance
  • Helicobacter pylori Infection
  • Real-Time PCR
  • qPCR
  • FFPE Gastric Biopsies
  • 23S rRNA Mutations
  • Gastric Biopsy
  • Antibiotic Resistance
03

In context

Lead sponsor

Clinique Bizet is the lead sponsor of 16 studies on the registry; 11 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Adults undergoing gastroscopy with gastric biopsies for suspected Helicobacter pylori infection. Participants must have confirmed H. pylori infection by histology and immunohistochemistry. Gastric biopsy samples will be analyzed by q-PCR on formalin-fixed paraffin-embedded (FFPE) tissue to evaluate detection of H. pylori and clarithromycin resistance-associated mutations.

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Age ≥18 years.
  • Ability to provide non-opposition to participate in the study.
  • Participants with suspected Helicobacter pylori infection requiring gastric during gastroscopy for H. pylori assessment by histopathology and bacteriology, including clarithromycin resistance testing by PCR.
  • Confirmed presence of Helicobacter pylori by histological examination and immunohistochemistry.

Exclusion criteria

Exclusion Criteria:

  • Minor participants.
  • Adults under legal protection, guardianship or curatorship.
  • Refusal to participate in the study.
  • Recent antibiotic therapy (\<4 weeks) that may affect bacterial load.
  • Recent proton pump inhibitor treatment (\<2 weeks).
  • Insufficient tissue quantity for complementary analyses.
  • Poor quality fixation or preservation of samples.
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
250 participants (estimated)
Patient registry
No

Interventions

  • Diagnostic testq-PCR on FFPE gastric biopsies

    Real-time PCR performed on formalin-fixed, paraffin-embedded (FFPE) gastric biopsy specimens to detect Helicobacter pylori and mutations associated with clarithromycin resistance.

06

What researchers measure

Primary outcomes

  1. Diagnostic performance of q-PCR on FFPE gastric biopsies for detection of Helicobacter pylori clarithromycin resistance

    Sensitivity and specificity of q-PCR performed on formalin-fixed paraffin-embedded (FFPE) gastric biopsies for: detection of Helicobacter pylori infection (using immunohistochemistry and internal PCR positive control as reference); detection of clarithromycin resistance-associated mutations (23S rRNA gene mutations); assessment of the proportion of exploitable samples (technical success rate); turnaround time for obtaining results.Sensitivity and specificity of q-PCR performed on formalin-fixed paraffin-embedded (FFPE) gastric biopsies for: detection of Helicobacter pylori infection (using immunohistochemistry and internal PCR positive control as reference); detection of clarithromycin resistance-associated mutations (23S rRNA gene mutations); assessment of the proportion of exploitable samples (technical success rate); turnaround time for obtaining results.

    Time frame: Within 10 days after gastric biopsy collection

Secondary outcomes

  1. Prevalence of clarithromycin resistance in Helicobacter pylori infection

    Prevalence of clarithromycin resistance-associated mutations according to age, sex, clinical indication and clinical setting.

    Time frame: Within 10 days after gastric biopsy collection

  2. Concordance between q-PCR FFPE and immunohistochemistry results

    Agreement between q-PCR performed on FFPE gastric biopsies and immunohistochemistry results, particularly in cases with low bacterial load.

    Time frame: Within 15 days after gastric biopsy collection

  3. Concordance between q-PCR FFPE and bacteriological PCR results

    Agreement between q-PCR performed on FFPE gastric biopsies and reference PCR performed on bacteriological samples (and culture when available).

    Time frame: Within 15 days after gastric biopsy collection

  4. Impact of q-PCR results on therapeutic management

    Proportion of participants whose treatment strategy is modified based on q-PCR results, including prescription of a treatment guided by clarithromycin susceptibility profile.

    Time frame: Within 15 days after inclusion and availability of laboratory results

  5. Medical-economic impact of q-PCR FFPE strategy

    Comparison of costs between q-PCR FFPE strategy and current empirical or bacteriological PCR-based strategies, including cost per adapted treatment and cost per avoided therapeutic failure.

    Time frame: Through study completion, an average of 12 months

07

Study locations

1 of 1 sites recruiting
08

References and documents

Publications

  • Nezami BG, Jani M, Alouani D, Rhoads DD, Sadri N. Helicobacter pylori Mutations Detected by Next-Generation Sequencing in Formalin-Fixed, Paraffin-Embedded Gastric Biopsy Specimens Are Associated with Treatment Failure. J Clin Microbiol. 2019 Jun 25;57(7):e01834-18. doi: 10.1128/JCM.01834-18. Print 2019 Jul. PubMed 31068413 ↗
  • Schmitt BH, Regner M, Mangold KA, Thomson RB Jr, Kaul KL. PCR detection of clarithromycin-susceptible and -resistant Helicobacter pylori from formalin-fixed, paraffin-embedded gastric biopsies. Mod Pathol. 2013 Sep;26(9):1222-7. doi: 10.1038/modpathol.2013.48. Epub 2013 Apr 12. PubMed 23579617 ↗
  • Oleastro M, Menard A, Santos A, Lamouliatte H, Monteiro L, Barthelemy P, Megraud F. Real-time PCR assay for rapid and accurate detection of point mutations conferring resistance to clarithromycin in Helicobacter pylori. J Clin Microbiol. 2003 Jan;41(1):397-402. doi: 10.1128/JCM.41.1.397-402.2003. PubMed 12517879 ↗
  • Malfertheiner P, Megraud F, Rokkas T, Gisbert JP, Liou JM, Schulz C, Gasbarrini A, Hunt RH, Leja M, O'Morain C, Rugge M, Suerbaum S, Tilg H, Sugano K, El-Omar EM; European Helicobacter and Microbiota Study group. Management of Helicobacter pylori infection: the Maastricht VI/Florence consensus report. Gut. 2022 Aug 11;71(9):1724-1762. doi: 10.1136/gutjnl-2022-327745. PubMed 35944925 ↗

Individual participant data

Plan to share: No

09

Updates

1 registry update since Sep 25, 2026
Status
Not yet recruiting→Recruiting
changed Oct 27, 2026
Sites
Benkessou is now Recruiting
Oct 27, 2026
Start date
Sep 1, 2026→Sep 10, 2026 (actual)
Oct 27, 2026
Show all 1 update
  1. Oct 27, 2026
    Not yet recruiting→Recruiting
    Benkessou is now Recruiting
    Start date Sep 1, 2026→Sep 10, 2026 (now actual)

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT07821294
Lead sponsor
Clinique Bizet
Responsible party
Sponsor
First posted
Sep 15, 2026
Start date
Sep 10, 2026
Primary completion
Feb 28, 2027 (estimated)
Completion
Aug 6, 2027 (estimated)
Last update
Oct 27, 2026

Study contacts

Bouchra BENKESSOU
Contact
b.benkessou@hexagone-sante-paris.fr
07 64 48 60 16
Dr Michaël Lévy
principal investigator · Clinique Bizet

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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