The efficacy of vonoprazan combined with different dose amoxicillin on eradication of Helicobacter pylori: an open, multicenter, randomized clinical study

Lin, Yun; Xu, Huimei; Yun, Jianwei; Yu, Xiaofang; Shi, Yue; Zhang, Dekui

doi:10.21037/atm-22-4133

Cited by 20 publications

(46 citation statements)

References 26 publications

(39 reference statements)

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“…VA dual therapy for 7 days achieved low eradication rates (< 80%). 10,26 Qian et al 27 studied 250 H. pylori-infected subjects who received VPZ in combination with a low (1 g b.i.d.) or high (0.75 g q.i.d.)…”

Section: Discussionmentioning

confidence: 99%

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Research trends on vonoprazan‐based therapy for Helicobacter pylori eradication: A bibliometric analysis from 2015 to 2023

Ouyang

et al. 2023

Helicobacter

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BackgroundVonoprazan is an emerging option for the treatment of Helicobacter pylori infection. We aimed to assess the research trends and hotspots of vonoprazan‐based therapy for H. pylori eradication through bibliometric analysis.Materials and MethodsVonoprazan‐based studies for eradicating H. pylori published from 2015 to 2023 were extracted from the Web of Science using a combination of the search terms “H. pylori” and “vonoprazan.” Each study was weighted according to the number of included patients.ResultsA total of 65 studies were included. Japan was the most productive and cooperative country, accounting for 69.2% of publications. Vonoprazan in combination with amoxicillin and clarithromycin (41.8%) was most used for eradicating H. pylori, followed by vonoprazan in combination with amoxicillin (20.4%) and vonoprazan in combination with amoxicillin and metronidazole (19.4%). The eradication rates for first‐line vonoprazan‐based therapies by intention to treat were: dual therapy (82.9%, 95% CI: 77.7%–88.0%), triple (83.3%, 95% CI: 79.7%–86.8%) and quadruple therapy (91.5%, 95% CI: 85.5%–97.4%), and per protocol: dual therapy (86.1%, 95% CI: 81.5%–90.7%), triple (89.3%, 95% CI: 87.9%–90.6%) and quadruple therapy (94.0%, 95% CI: 88.6%–99.4%). Vonoprazan was superior to proton pump inhibitors in triple therapy regarding empirical therapy (RR = 1.18, 95% CI, 1.14–1.22, p < 0.01) and clarithromycin‐resistant group (RR = 1.71, 95% CI, 1.33–2.20, p < 0.01), but there is no significant difference between triple therapy and dual therapy (RR = 1.02, 95% CI, 0.98–1.07, p = 0.33).ConclusionsVonoprazan has been widely used for H. pylori eradication. Further studies are needed to optimize the best duration and dosage of vonoprazan‐based regimens in different regions.

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Section: Discussionmentioning

confidence: 99%

“…The efficacy of VA dual therapy for 7‐, 10‐, and 14‐day VA dual therapy had been explored in China. VA dual therapy for 7 days achieved low eradication rates (< 80%) 10,26 . Qian et al 27 studied 250 H. pylori ‐infected subjects who received VPZ in combination with a low (1 g b.i.d.)…”

Section: Discussionmentioning

confidence: 99%

Research trends on vonoprazan‐based therapy for Helicobacter pylori eradication: A bibliometric analysis from 2015 to 2023

Ouyang

et al. 2023

Helicobacter

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“…After the title and abstract screening, 56 studies were excluded. 22 studies were reviewed as full text and six studies were included in the final analysis [25][26][27][28][29][30] (Figure 1). Among 6 studies included, three were conducted in Japan, one in Pakistan, one in the United States and Europe, and one in China.…”

Section: Study Characteristics and Quality Assessmentmentioning

confidence: 99%

The Efficacy and Safety of Vonoprazan and Amoxicillin Dual Therapy for Helicobacter pylori Infection: A Systematic Review and Network Meta-Analysis

Liu

Shi

et al. 2023

Antibiotics

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The eradication of Helicobacter pylori (H. pylori) infection remains challenging due to increasing bacterial resistance. Resistance rates to clarithromycin, metronidazole, and levofloxacin were higher than 30% in the USA, making current therapies less effective. Vonoprazan triple therapy (VAC) has demonstrated similar efficacy and safety profiles compared to PPI-based triple therapy (PPI). However, the eradication rate of vonoprazan dual therapy (VA) for H. pylori infection in comparison to VAC, and PPI was poorly established. Electronic databases were searched up to 6 October 2022, to identify studies examining the safety and efficacy of VA compared to VAC and PPI. Six studies were included. For empiric therapies among treatment naïve patients, VA, VAC, and PPI did not achieve high cure rates (>90%). The comparative efficacy ranking showed VAC was the most effective therapy, followed by VA, and PPI. The results were similar for clarithromycin-resistant infections. The comparative safety ranking showed VA ranked first, whereas PPI triple therapy was the least safe regimen. These findings should guide the selection of the most effective and safe treatment and conduct additional studies to determine the place of vonoprazan dual versus triple therapies in patients with H. pylori from various countries across the world.

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“…Suzuki et al 28 and Lin et al 33 compared the combination of vonoprazan and amoxicillin with vonoprazan, amoxicillin, and clarithromycin given for 7 days in clinical trials. No significant difference in eradication rate was found in both intention-to-treat and per-protocol analyses (each P > 0.05).…”

Section: Pharmacologymentioning

confidence: 99%

Vonoprazan With Amoxicillin or Amoxicillin and Clarithromycin for the Treatment of Helicobacter pylori Infection

Liu

Nahata

2023

Ann Pharmacother

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Objectives: To describe the pharmacology, efficacy, safety, and potential role of vonoprazan with amoxicillin or amoxicillin and clarithromycin for the treatment of Helicobacter pylori infection in adults. Data Sources: PubMed, Embase, Cochrane Library, and ClinicalTrials.gov were searched using the terms: (vonoprazan OR voquezna) AND (“ H. pylori” OR “ Helicobacter pylori”) AND amoxicillin with no date limitations up to November 3, 2022. Study Selection and Data Extraction: Studies assessing the efficacy and safety of vonoprazan with amoxicillin and/or clarithromycin were included and divided into 3 groups based on different comparisons between treatment regimens used in each group. Data Synthesis: Ten clinical trials and 17 observational studies were included. Vonoprazan-based therapy demonstrated greater acid inhibition and similar or higher efficacy than proton-pump inhibitor (PPI)-based therapy in treatment-naïve patients and with clarithromycin-resistant infections. Relevance to Patient Care and Clinical Practice: Proton-pump inhibitor-based therapies have not reached the desired successful eradication rate of 90% for H. pylori infection. Vonoprazan-based therapies being at least as effective as PPI-based therapies offer an alternative for patients with H. pylori infection. Conclusion: Vonoprazan-based therapies were effective and well tolerated for the treatment of H. pylori infection in adults. These regimens provide an important alternative with prolonged acid inhibition, lower potential for CYP2C19 polymorphism, and at least comparable efficacy and safety versus PPI-based therapies in patients with H. pylori infections. Thus, vonoprazan-based therapy should be considered for certain patients, for example, those with failure to PPI-based treatments.

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The efficacy of vonoprazan combined with different dose amoxicillin on eradication of Helicobacter pylori: an open, multicenter, randomized clinical study

Abstract: Contributions: (I) Conception and design: Y Lin, D Zhang; (II) Administrative support: D Zhang; (III) Provision of study materials or patients: Y Lin,

Cited by 20 publications

References 26 publications

Research trends on vonoprazan‐based therapy for Helicobacter pylori eradication: A bibliometric analysis from 2015 to 2023

Research trends on vonoprazan‐based therapy for Helicobacter pylori eradication: A bibliometric analysis from 2015 to 2023

The Efficacy and Safety of Vonoprazan and Amoxicillin Dual Therapy for Helicobacter pylori Infection: A Systematic Review and Network Meta-Analysis

Vonoprazan With Amoxicillin or Amoxicillin and Clarithromycin for the Treatment of Helicobacter pylori Infection

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