Pre‐treatment with proton pump inhibitors decreases the success of primary <i>Helicobacter pylori</i> eradication using a vonoprazan‐based regimen

Shinozaki, Satoshi; Osawa, Hiroyuki; Sakamoto, Hirotsugu; Hayashi, Yoshikazu; Kobayashi, Yasutoshi; Mıura, Yoshimasa; Lefor, Alan Kawarai; Yamamoto, Hironori

doi:10.1016/j.kjms.2018.03.009

Cited by 8 publications

(17 citation statements)

References 23 publications

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“…Second, VA‐dual may be less affected by common use or concomitant drugs. Shinozaki et alreported that pre‐treatment with PPI decreases the eradication rate when VAC‐triple is used 12 . In contrast, in the present study, the use of PPIs before eradication therapy did not affect the eradication rate of VA‐dual.…”

Section: Discussioncontrasting

confidence: 79%

Impact of body size on first‐line Helicobacter pylori eradication success using vonoprazan and amoxicillin dual therapy

et al. 2021

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Background As a first‐line therapy for Helicobacter pylori, dual therapy with vonoprazan and amoxicillin (VA‐dual) provides an eradication rate similar to that of vonoprazan‐based triple therapy. As the factors associated with the eradication rate of H. pylori with VA‐dual are unknown,we investigated them in this study. Materials and Methods Overall, 163 patients diagnosed with H. pylori infection received VA‐dual (vonoprazan 20 mg twice daily and amoxicillin 750 mg twice daily for 7 d). The association between successful H. pylori eradication and the following patient clinical factors was analyzed: sex, age, height, weight, body surface area (BSA), body mass index (BMI), history of early gastric carcinoma and peptic ulcer, comorbidity of cirrhosis, alcohol consumption habit, smoking habit, common use of proton pump inhibitors, and concomitant use of drugs that are substratesof cytochrome P450 (CYP) 3A4. The association between post‐eradication adverse events and clinical factors was analyzed retrospectively. Results Successful H. pylori eradication was associated with a lower BSA (eradication rate: 90.8% in patients with BSA <1.723 vs. 79.6% in those with BSA ≥1.723; p = 0.045). The incidence of adverse events was higher in women than in men (adverse events: 40.0% in women vs. 19.4% in men; p = 0.004). Conclusions Successful H. pylori eradication with VA‐dual was associated with the small body size of patients. This therapy may have to be adjusted per body size.

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Section: Discussioncontrasting

confidence: 79%

Impact of body size on first‐line Helicobacter pylori eradication success using vonoprazan and amoxicillin dual therapy

et al. 2021

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“…In recent years, several studies have compared eradication rates between VPZ-containing and PPI-containing triple therapies across centers in Japan. As shown in Table 2, up until September 2018, 23 reports had investigated the efficacy of first-line VPZ-containing therapy (21 reports for VPZ/AMX/CLR and 2 reports for VPZ/MNZ/CLR) (Matsumoto et al, 2016; Murakami et al, 2016; Noda et al, 2016; Shichijo et al, 2016; Shinozaki et al, 2016, 2018; Suzuki et al, 2016; Tsujimae et al, 2016; Yamada et al, 2016; Kajihara et al, 2017; Katayama et al, 2017; Maruyama et al, 2017; Nishizawa et al, 2017; Ono et al, 2017; Sakurai et al, 2017; Sue et al, 2017a,b, 2018a; Sugimoto et al, 2017; Tanabe et al, 2017, 2018; Mori et al, 2018; Ozaki et al, 2018), and 19 reports had compared the efficacy between VPZ-containing therapy and PPI-containing therapy, including 3 randomized control trials (Murakami et al, 2016; Maruyama et al, 2017; Sue et al, 2018a) and 16 non-randomized retrospective cohort trials (Matsumoto et al, 2016; Noda et al, 2016; Shichijo et al, 2016; Shinozaki et al, 2016; Suzuki et al, 2016; Tsujimae et al, 2016; Yamada et al, 2016; Kajihara et al, 2017; Nishizawa et al, 2017; Ono et al, 2017; Sakurai et al, 2017; Sue et al, 2017a,b; Mori et al, 2018; Ozaki et al, 2018; Tanabe et al, 2018).…”

Section: First-line Vonoprazan-containing Eradication Therapymentioning

confidence: 99%

“…As shown in Table 2, first-line triple VPZ-containing therapies (VPZ/AMX/CLR) therefore show superior efficacy in Japanese individuals in terms of H. pylori eradication compared to PPI-containing therapies (Matsumoto et al, 2016; Murakami et al, 2016; Noda et al, 2016; Shichijo et al, 2016; Shinozaki et al, 2016, 2018; Suzuki et al, 2016; Tsujimae et al, 2016; Yamada et al, 2016; Kajihara et al, 2017; Katayama et al, 2017; Maruyama et al, 2017; Nishizawa et al, 2017; Ono et al, 2017; Sakurai et al, 2017; Sue et al, 2017a,b, 2018a; Sugimoto et al, 2017; Tanabe et al, 2017, 2018; Mori et al, 2018; Ozaki et al, 2018). According to a grading system established by Graham et al (2007) the 69.1–75.0% eradication rate of PPI-containing therapies constitutes an unacceptable grade (grade F).…”

Section: First-line Vonoprazan-containing Eradication Therapymentioning

confidence: 99%

Role of Vonoprazan in Helicobacter pylori Eradication Therapy in Japan

Sugimoto

Yamaoka

2019

Front. Pharmacol.

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Complete eradication of Helicobacter pylori is important for preventing the development of gastric cancer. The outcome of H. pylori eradication therapy is mainly dependent on bacterial susceptibility to antimicrobial agents and potent neutralization of intragastric pH across 24 h, especially when using acid-sensitive antimicrobial agents such as clarithromycin (CLR), amoxicillin and sitafloxacin. However, conventional regimens comprising twice-daily doses (bid) of proton pump inhibitors (PPIs) are generally insufficient for maintaining the required gastric acid secretion for 24 h for successful eradication in all H. pylori-positive patients. Further, the increasing prevalence of CLR-resistant strains with each year has led to a decrease in eradication rates of first-line PPI- and CLR-containing therapies in developed countries, including Japan. In 2015, the potassium-competitive acid blocker vonoprazan (VPZ) became clinically available in Japan. VPZ competitively inhibits H+/K+-ATPase activity more potently than PPIs (e.g., omeprazole, lansoprazole, rabeprazole, pantoprazole, and esomeprazole). Therefore, a VPZ-containing H. pylori eradication regimen is expected to increase the eradication rate compared with conventional regimens containing a standard dose of PPI. In fact, a recent meta-analysis that investigated the efficacy of first-line eradication therapy showed that a VPZ-containing regimen achieved a higher eradication rate than a PPI-containing regimen. While the Maastricht V/Florence Consensus Report recommends selecting a bismuth or non-bismuth quadruple therapy and concomitant therapy for patients living in areas with high prevalence of CLR resistance, a VPZ-containing regimen demonstrates effectiveness for patients infected with CLR-resistant strains and patients living in areas where the prevalence of CLR-resistant strains is >15%. As a next step, studies are needed to determine the factors affecting the clinical outcome of VPZ-containing therapy and optimal VPZ-containing alternative regimens for tailored treatments. In this review, we summarize the advantages and disadvantages of VPZ in H. pylori eradication therapy.

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“…All patients underwent esophagogastroduodenoscopy prior to eradication therapy. H. pylori infection status was confirmed by a rapid urease test, stool antigen test, histology, serum IgG, or 13 C-urea breath test (UBT). The degree of gastric atrophy was classified based on the Kimura-Takemoto classification [11].…”

Section: Methodsmentioning

confidence: 99%

“…Exclusion criteria included missing data (height, weight, or endoscopic findings), pre-treatment with a PPI or H2RA, firstline eradication therapy with a PCAB-based regimen, or a history of distal gastrectomy. Since we recently reported that PPI and H2RA decreased the success of H. pylori eradication [13], patients previously treated with PPI or H2RA were excluded from this study to eliminate a possible source of bias. All patients who underwent PPI-based second-line therapy had not undergone PCAB-based first-line therapy.…”

Section: Second-line H Pylori Eradication Regimen and Treatment Outcomementioning

confidence: 99%

A Potassium-Competitive Acid Blocker-Based Regimen as Second-Line Therapy Improves Helicobacter pylori Eradication

et al. 2019

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Background/Aims: Although a potassium-competitive acid blocker (PCAB)-based regimen improves the rate of successful Helicobacter pylori first-line eradication, the efficacy of a PCAB-based regimen as second-line therapy is unclear. The aim of this study is to compare the success of second-line eradication of H. pylori using PCAB and proton pump inhibitor (PPI)-based regimens. Methods: From 2014 to 2017, 624 patients who underwent second-line H. pylori eradication were enrolled. A standard triple regimen for second-line H. pylori eradication includes metronidazole 250 mg, amoxicillin 750 mg, and PPI or PCAB twice daily for 7 days. The success of eradication was compared using intention-to-treat, per-protocol, and propensity-score matching analysis. Results: All patients completed the 7-day course of therapy. Patients using a PCAB-based regimen had a higher rate of eradication than those using a PPI-based regimen in both intention-to-treat (90% [298/330] vs. 85% [250/294], p = 0.045) and per-protocol analyses (96% [298/309] vs. 91% [250/274], p = 0.008). Adverse events occurred in 4 patients. Propensity score matching analysis acquired 274 matched pairs. Patients using a PCAB-based regimen had a higher rate of eradication than those using a PPI-based regimen (96% [264/274] vs. 91% [250/274], p = 0.013). Conclusions: PCABbased second-line H. pylori eradication is significantly better than PPI-based therapy.

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Pre‐treatment with proton pump inhibitors decreases the success of primary Helicobacter pylori eradication using a vonoprazan‐based regimen

Cited by 8 publications

References 23 publications

Impact of body size on first‐line Helicobacter pylori eradication success using vonoprazan and amoxicillin dual therapy

Impact of body size on first‐line Helicobacter pylori eradication success using vonoprazan and amoxicillin dual therapy

Role of Vonoprazan in Helicobacter pylori Eradication Therapy in Japan

A Potassium-Competitive Acid Blocker-Based Regimen as Second-Line Therapy Improves Helicobacter pylori Eradication

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