Vonoprazan‐ vs proton‐pump inhibitor‐based first‐line 7‐day triple therapy for clarithromycin‐susceptible Helicobacter pylori: A multicenter, prospective, randomized trial

Abstract

The eradication rate of V-AC treatment in the CAM-susceptible H. pylori-infected patients was <90%, as was that by PPI-AC, thus V-AC is not ideal regimen in CAM-susceptible H. pylori. However, the 82.9% eradication rate of V-AC in the CAM-resistant infections may indicate the potential of V-AC with modified dose, dosing interval, and treatment duration. (UMIN000016337).

Systematic review with meta‐analysis: Vonoprazan, a potent acid blocker, is superior to proton‐pump inhibitors for eradication of clarithromycin‐resistant strains of Helicobacter pylori

“…As stated in the 2 RCTs included in our analysis, either vonoprazan‐based or PPI‐based therapy can achieve high eradication rates in patients with clarithromycin‐susceptible strains, while in patients with clarithromycin‐resistant strains both therapies achieved lower eradication rates . These data emphasize the importance of antibiotic resistance to the failure of eradication therapy.…”

“…Dong et al demonstrated that the odds ratio for H. pylori eradication using vonoprazan‐based therapy as compared to conventional PPI‐based therapy was greater for patients infected with clarithromycin‐resistant strains (OR: 5.92) than for patients infected with clarithromycin‐susceptible strains (OR: 2.02). Our results, based on data including that of the most recently published RCT on vonoprazan vs PPI in triple therapy for H. pylori eradication, also suggest that the efficacy of vonoprazan‐based triple therapies may be greatly affected by clarithromycin susceptibility …”

“…All 5 studies provided eradication rates based on clarithromycin susceptibility. However, 2 studies provided data for clarithromycin‐susceptible strains …”

Randomized trial of vonoprazan‐based versus proton‐pump inhibitor‐based third‐line triple therapy with sitafloxacin for Helicobacter pylori

“…The H. pylori status of all participants was determined using a urea breath test (UBT), H. pylori stool antigen test, detection of anti‐ H. pylori IgG, rapid urease test, or H. pylori culture (same procedure as in our previous study) (Table ). Endoscopy was performed within 1 year in all patients.…”

Treatment of Helicobacter pylori infection in 2018

“…A large Japanese trial comparing vonoprazan vs PPI in first‐line triple therapy reported a significantly higher eradication rate with vonoprazan (90.8%) compared to esomeprazole (77.5%) or rabeprazole (68.4%) . The eradication rates of vonoprazan with amoxicillin and clarithromycin in clarithromycin‐resistant patients were 82.9% …”