The efficacy and mechanism of vonoprazan-containing triple therapy in the eradication of Helicobacter pylori

Zhang, Zinan; Liu, Fen; Ai, Feiyan; Xiong, Chen; Li, Rui; Zhang, Chao; Fang, Ning; Fu, Tian; Wang, Xiaoyan; Tang, Anliu

doi:10.3389/fphar.2023.1143969

Cited by 6 publications

(11 citation statements)

References 62 publications

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“…A regressive study 19 that performed a propensity score‐matched analysis provides a level of evidence comparable to that of RCTs. Eight studies 18–22,24–26 were included in the PP analysis, and the results were consistent with those of the ITT analysis (shown in Figure 3). Particularly, the ERs of VPZ‐based regimens and PPIs‐based regimens (BQT) were 94.80% and 89.88%, respectively (OR = 2.25, 95% CI (1.37, 3.69), p = 0.001 < 0.05, shown in Figure 3).…”

Section: Resultssupporting

confidence: 55%

“…A total of 568 studies were obtained, and after eliminating duplicates and systematic evaluations, and reading their abstracts and entire text, a total of 10 18–27 studies were finally included (shown in Figure 1). Out of the 10 studies, one was NRCT 19 and nine were RCTs, 18,20–27 and all studies were conducted in China. A total of 2587 patients 15 were included; 1452 of them were in the VPZ‐based group, whereas 1135 of them were in the BQT group.…”

Section: Resultsmentioning

confidence: 99%

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Meta‐analysis of Helicobacter pylori eradication therapy using vonoprazan as an acid suppressor compared with bismuth quadruple therapy

Yang,

Zhang,

et al. 2024

Helicobacter

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BackgroundVonoprazan, a novel acid suppressant, has recently emerged as a regimen for eradicating Helicobacter pylori. However, uncertainties exist about the effectiveness and safety of VPZ‐based regimens compared with those of bismuth‐based quadruple therapy in eradicating H. pylori. The present meta‐analysis was performed to compare the effectiveness and safety of vonoprazan‐based regimens with those of bismuth quadruple therapy in eradicating H. pylori.Materials and MethodsAll randomized controlled trials and non‐randomized controlled trials comparing the vonoprazan‐based therapy with the bismuth quadruple therapy were included in this meta‐analysis. Information was also extracted by two evaluators, and if heterogeneity existed, a random‐effects model was used to calculate the combined relative ratio and 95% confidence interval; otherwise, a fixed‐effects model was used. And subgroup analyses were performed to explore the sources of heterogeneity.ResultsA total of 10 studies, comprising 2587 patients were included in the meta‐analysis. The results showed that the combined eradication rate of patients treated with the vonoprazan‐based regimen was significantly higher than that of patients treated with bismuth quadruple therapy, in both intention‐to‐treat and per‐protocol analyses, and the differences were statistically significant. Among the intention‐to‐treat analyses results: (90.28% vs. 83.64% [odds ratio (OR) = 1.85, 95% confidence interval (CI) (1.27, 2.70), p = 0.001]); in the per‐protocol analyses: (94.80% vs. 89.88%, [OR = 2.25, 95% CI (1.37, 3.69), p = 0.001]). The occurrence of adverse events was significantly lower in patients treated with vonoprazan‐based regimens than in those treated with bismuth quadruple therapy, (14.50% vs. 25.89%, [OR = 0.49, 95% CI (0.32, 0.75), p = 0.001]).ConclusionsFor eradicating H. pylori, vonoprazan‐based regimens are remarkably advantageous over bismuth quadruple therapy. Furthermore, vonoprazan‐based regimens exhibit a lower rate of adverse events than bismuth quadruple therapy.

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Section: Resultssupporting

confidence: 55%

Section: Resultsmentioning

confidence: 99%

Meta‐analysis of Helicobacter pylori eradication therapy using vonoprazan as an acid suppressor compared with bismuth quadruple therapy

Yang,

Zhang,

et al. 2024

Helicobacter

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“…A total of 20 RCTs were included, 15 , 16 , 22 – 39 involving 5815 patients with Hp infection, with 3153 patients in the treatment group, and 2662 patients in the control group. The basic characteristics of the included studies are shown in Tables 1 and 2 .…”

Section: Resultsmentioning

confidence: 99%

P-CAB versus PPI in the eradication of Helicobacter pylori: a systematic review and network meta-analysis

Jiang,

Zhang,

Fang

et al. 2024

Therap Adv Gastroenterol

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Background: The efficacy and safety of potassium-competitive acid blockers (P-CABs) in the eradication of Helicobacter pylori (Hp) remains controversial when compared with proton pump inhibitors (PPIs). Objectives: The current study set out to compare the differences in the eradication rate and adverse reactions between eradication regimens based on P-CAB or PPI drugs and the differences between the vonoprazan-based and the tegoprazan-based regimens to explore the efficacy and safety of different Hp eradication regimens. Data sources and methods: Databases including PubMed, EMBASE, Cochrane Library, and WOS were searched from the inception of these databases up to July 2023, and eligible randomized controlled trials (RCTs) were included. The outcome measures were the eradication rate and the incidence of adverse reactions of different regimens in treating Hp. The results were estimated as relative risk (RR) and its 95% confidence interval (CI), and R 4.2.1 software was used to perform the network meta-analysis (NMA). Results: A total of 20 studies were included in the analysis, involving 5815 patients with Hp. In terms of eradication rate, the 2-week vonoprazan-based triple regimen (V-Tri-2w) was the best, which was superior to the 2-week PPI-based quadruple regimen [P-Qua-2w, RR = 0.9, 95% CI: (0.85–0.95)] and the 1-week tegoprazan-based triple regimen [T-Tri-1w, RR = 0.79, 95% CI: (0.64–0.97)]; the 2-week tegoprazan-based quadruple regimen (T-Qua-2w) was superior to the 1-week PPI-based triple regimen [P-Tri-1w, RR = 0.82, 95% CI: (0.67–0.99)], and there was no difference between the remaining tegoprazan-based regimens and the PPI-based or vonoprazan-based regimens. In terms of the incidence of adverse reactions, the 2-week vonoprazan-based binary regimen (V-Bi-2w) was lower than that of the 2-week PPI-based quadruple regimen [P-Qua-2w, RR = 1.98, 95% CI: (1.57–2.52)]; there was no significant difference between 1 and 2 weeks for each regimen, such as the vonoprazan-based triple regimen [RR = 1.11, 95% CI: (0.82–1.52)]. Conclusion: In the eradication treatment of Hp, the efficacy and safety of vonoprazan-based regimens are generally better than those of PPI-based regimens. Among them, the V-Tri-2w regimen has the highest eradication rate and may be the preferred choice for Hp eradication.

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“…Despite the recent interest in H. pylori infection and management, biofilms are still quite understudied. Little information is available about the mechanisms involved in antibiotic tolerance and resistance (Hathroubi et al 2020b ; Zhang et al 2023 ). Multiple techniques, including genomic, proteomic, transcriptomic, and target-specific investigations, have been employed to determine the factors affecting biofilm formation.…”

Section: Introductionmentioning

confidence: 99%

Helicobacter pylori in the post-antibiotics era: from virulence factors to new drug targets and therapeutic agents

Al-Fakhrany,

Elekhnawy

2023

Arch Microbiol

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Helicobacter pylori is considered one of the most prevalent human pathogenic microbes globally. It is the main cause of a number of gastrointestinal ailments, including peptic and duodenal ulcers, and gastric tumors with high mortality rates. Thus, eradication of H. pylori is necessary to prevent gastric cancer. Still, the rise in antibiotic resistance is the most important challenge for eradication strategies. Better consideration of H. pylori virulence factors, pathogenesis, and resistance is required for better eradication rates and, thus, prevention of gastrointestinal malignancy. This article is aimed to show the role of virulence factors of H. pylori. Some are involved in its survival in the harsh environment of the human gastric lumen, and others are related to pathogenesis and the infection process. Furthermore, this work has highlighted the recent advancement in H. pylori treatment, as well as antibiotic resistance as a main challenge in H. pylori eradication. Also, we tried to provide an updated summary of the evolving H. pylori control strategies and the potential alternative drugs to fight this lethal resistant pathogen. Recent studies have focused on evaluating the efficacy of alternative regimens (such as sequential, hybrid, concomitant treatment, vonoprazan (VPZ)-based triple therapy, high-dose PPI-amoxicillin dual therapy, probiotics augmented triple therapy, or in combination with BQT) in the effective eradication of H. pylori. Thus, innovating new anti-H. pylori drugs and establishing H. pylori databanks are upcoming necessities in the near future.

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The efficacy and mechanism of vonoprazan-containing triple therapy in the eradication of Helicobacter pylori

Cited by 6 publications

References 62 publications

Meta‐analysis of Helicobacter pylori eradication therapy using vonoprazan as an acid suppressor compared with bismuth quadruple therapy

Meta‐analysis of Helicobacter pylori eradication therapy using vonoprazan as an acid suppressor compared with bismuth quadruple therapy

P-CAB versus PPI in the eradication of Helicobacter pylori: a systematic review and network meta-analysis

Helicobacter pylori in the post-antibiotics era: from virulence factors to new drug targets and therapeutic agents

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