title: The Efficacy and Tolerability of a Triple Therapy Containing a Potassium-Competitive Acid Blocker Compared With a 7-Day PPI-Based Low-Dose Clarithromycin Triple Therapy.
abstract: This study evaluated the efficacy and tolerability of potassium-competitive acid blocker (P-CAB), a new class of gastric acid inhibitory agents, as first-line H. pylori eradication treatment compared with 7-day proton pump inhibitor (PPI)-based triple therapy.
  
  
  
  We retrospectively reviewed the medical records of 661 consecutive patients who received first-line H. pylori eradication treatment between January 2013 and October 2015. Patients who received 7-day P-CAB therapy (vonoprazan 20 mg+amoxicillin 750 mg+clarithromycin 200 mg twice/day; n=181) were compared with those who received 7-day PPI therapy (lansoprazole 30 mg/rabeprazole 20 mg+amoxicillin 750 mg+clarithromycin 200 mg twice/day; n=480) using propensity score matching analysis. The successful eradication and adverse event rates were compared between the two groups.
  
  
  
  The propensity score matching analysis yielded 175 matched pairs. Adjusted comparisons between the two groups showed a significantly higher eradication rate for the P-CAB than the PPI group in both intention-to-treat (89.1 vs. 70.9%; P<0.001) and per-protocol analyses (91.2 vs. 71.7%; P<0.001). There was no significant difference in the incidence of adverse events between the two therapies except skin rash. No patients discontinued H. pylori eradication treatment because of adverse events.
  
  
  
  Seven-day P-CAB-based triple therapy was more effective than 7-day PPI-based triple therapy as a first-line H. pylori eradication treatment. Seven-day P-CAB-based triple therapy was generally well-tolerated.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.|Department of Gastroenterology, Yuri-Kumiai General Hospital, Akita, Japan.
authors.forename: Sho
authors.initials: S
authors.lastname: Suzuki
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Takuji
authors.initials: T
authors.lastname: Gotoda
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.|Department of Gastroenterology, Yuri-Kumiai General Hospital, Akita, Japan.
authors.forename: Chika
authors.initials: C
authors.lastname: Kusano
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Kunio
authors.initials: K
authors.lastname: Iwatsuka
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Moriyama
mesh_terms: D000368:Aged; D000658:Amoxicillin / Q000008:administration & dosage / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects; D001944:Breath Tests / Q000379:methods; D017291:Clarithromycin / Q000008:administration & dosage / Q000009:adverse effects; D016903:Drug Monitoring / Q000379:methods; D004359:Drug Therapy, Combination / Q000379:methods*; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy; D016480:Helicobacter pylori / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D064747:Lansoprazole / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D011758:Pyrroles / Q000008:administration & dosage / Q000009:adverse effects; D064750:Rabeprazole / Q000008:administration & dosage / Q000009:adverse effects; D012189:Retrospective Studies; D013449:Sulfonamides / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: C552956:1-(5-(2-fluorophenyl)-1-(pyridin-3-ylsulfonyl)-1H-pyrrol-3-yl)-N-methylmethanamine; D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors; D011758:Pyrroles; D013449:Sulfonamides; D064747:Lansoprazole; D064750:Rabeprazole; D000658:Amoxicillin; D017291:Clarithromycin