Smoking and Drinking Did Not Increase the Failure of Therapeutic Helicobacter pylori Eradication by Vonoprazan, Clarithromycin, and Amoxicillin

Abstract

Aims: The influence of lifestyle-related factors, including smoking and drinking, was evaluated for Helicobacter pylori eradication therapy with vonoprazan or proton pump inhibitors (PPIs). Methods: Between 2012 and 2016, the medical records of 620 patients receiving H. pylori eradication therapy at Saiseikai Karatsu Hospital were evaluated. Patients had received vonoprazan (20 mg) or PPIs with 200 mg clarithromycin and 750 mg amoxicillin twice daily for 7 days. The influence of lifestyle-related factors on eradication failure was determined in the 2 groups. Results: The eradication rates for vonoprazan and lansoprazole, rabeprazole, and esomeprazole were, respectively, 91.0, 73.8, 72.0, and 84.6%. The vonoprazan eradication rate was significantly higher than those for the PPIs (p < 0.01). Habitual smoking and drinking did not increase eradication failure, and smoking and drinking during the eradication period did not reduce the eradication rate. Metabolic syndrome-related factors including obesity, hypertension, and diabetes mellitus had no negative influence on the eradication rate. Eradication with vonoprazan was more effective compared with that achieved through the use of PPIs. Conclusion: Lifestyle-related factors including smoking and drinking did not exacerbate the H. pylori eradication failure, and vonoprazan was more effective than the PPIs.

The safety and effectiveness of vonoprazan-basedHelicobacter pylorieradication therapy; a prospective post-marketing surveillance

“…In the current study, no notable difference in eradication rate was observed when stratified by patient demographic characteristics in first-line eradication therapy. Takara et al reported that lifestyle-related factors did not impact the eradication rate of vonoprazan-based triple therapy in their retrospective analysis [13]. These results support our findings.…”

“…Efficacy and safety information from the phase III study were limited to patients with gastric ulcer or duodenal ulcer scars. Furthermore, information on patient characteristics that influence the safety and effectiveness of vonoprazan-based triple therapy is limited [13]. We conducted a post-marketing surveillance study to investigate the safety and effectiveness of the combination therapy of vonoprazan-based triple therapy in routine clinical practice including patients with idiopathic thrombocytopenic purpura, history of endoscopic treatment of early gastric cancer, and gastritis.…”

Current status of first- and second-line Helicobacter pylori eradication therapy in the metropolitan area: a multicenter study with a large number of patients

“…Ample studies have demonstrated that efficacy of VPZ, AMPC, and CAM triple therapy was superior to that of PPIs, AMPC, and CAM triple therapy. 9,10,23–26 In our study, the proportion of VPZ-containing therapy in first-line therapy started at 45.6% in 2015, sharply increasing to 95.5% in 2018. A rapid increase in the proportion of VPZ-containing therapy should reflect the backward increase of the successful eradication ratio from 2015 to 2018.…”

Decline incidence in upper gastrointestinal bleeding in several recent years: data of the Japan claims database of 13 million accumulated patients

“…The incidence of peptic ulcers caused by H. pylori infection has markedly decreased in Japan because eradication therapy for H. pylori has been widely accepted. (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) Additionally, the infection rate of H. pylori has markedly decreased in Japan, (20,(31)(32)(33) especially in younger generations; the infection rate in junior high school students is <5%. (34) PPIs have recently become more frequently prescribed for secondary prevention of peptic ulcers and upper GI bleeding induced by NSAIDs and/or aspirin in Japan, (2,(35)(36)(37)(38) although the prescription of aspirin has increased in a time-dependent manner as demonstrated in Fig.…”