title: Vonoprazan versus conventional proton pump inhibitor-based triple therapy as first-line treatment against Helicobacter pylori: A multicenter retrospective study in clinical practice.
abstract: OBJECTIVE
  Vonoprazan is a potassium-competitive acid blocker, a new type of acid-suppressing drug, and has recently become available for peptic ulcers, gastroesophageal reflux disease, and Helicobacter pylori (H. pylori) eradication. Its efficacy for H. pylori eradication has been reported. However, the evidence for its efficacy and feasibility remains limited. We aimed to compare the feasibility, effectiveness and safety of vonoprazan-based triple therapy with conventional proton pump inhibitor (PPI)-based triple therapy in multicenter clinical practice.
  
  
  METHODS
  We performed a multicenter retrospective study on patients receiving first-line H. pylori eradication therapy between March 2013 and November 2015 with either vonoprazan-based triple therapy or conventional PPI-based triple therapy.
  
  
  RESULTS
  A total of 2715 patients aged 63.0 ± 12.1 years (1412 [52.0%] males) were analyzed. Eradication rates were 87.2% (368/422) for vonoprazan-based therapy and 72.4% (1661/2293) for conventional PPI-based therapy (P < 0.01). Among the former group, there were 10 cases of diarrhea, six of nausea/vomiting, and five of rash, but the rates of these adverse events were similar to those in the conventional PPI group.
  
  
  CONCLUSIONS
  Vonoprazan-based triple therapy is feasible, and has a higher rate for H. pylori eradication than conventional PPI as a first-line regimen.
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Satoki
authors.initials: S
authors.lastname: Shichijo
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Hirata
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Ryota
authors.initials: R
authors.lastname: Niikura
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Yoku
authors.initials: Y
authors.lastname: Hayakawa
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Atsuo
authors.initials: A
authors.lastname: Yamada
authors.affiliation: Department of Gastroenterology, Tokatsu-Tsujinaka Hospital, Chiba, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Mochizuki
authors.affiliation: Department of Gastroenterology, Tokatsu-Tsujinaka Hospital, Chiba, Japan.
authors.forename: Keigo
authors.initials: K
authors.lastname: Matsuo
authors.affiliation: Department of Gastroenterology, Kanto Central Hospital, Tokyo, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Isomura
authors.affiliation: Department of Gastroenterology, Kanto Central Hospital, Tokyo, Japan.
authors.forename: Motoko
authors.initials: M
authors.lastname: Seto
authors.affiliation: Institute for Adult Disease, Asahi Life Foundation, Tokyo, Japan.
authors.forename: Nobumi
authors.initials: N
authors.lastname: Suzuki
authors.affiliation: Department of Gastroenterology, Japanese Red Cross Medical Center, Tokyo, Japan.
authors.forename: Hirobumi
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Department of Gastroenterology, Japanese Red Cross Medical Center, Tokyo, Japan.
authors.forename: Shinzo
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Kyoundo Hospital, Tokyo, Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Sugimoto
authors.affiliation: Department of Gastroenterology, JR Tokyo General Hospital, Tokyo, Japan.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Omae
authors.affiliation: Department of Gastroenterology, JR Tokyo General Hospital, Tokyo, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Okamoto
authors.affiliation: Wakamiyawatabe Clinic, Chiba, Japan.
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Watabe
authors.affiliation: Department of Gastroenterology, Teikyo University Chiba Medical Center, Chiba, Japan.|Department of Gastroenterology, Sanno Medical Center, Tokyo, Japan.
authors.forename: Goichi
authors.initials: G
authors.lastname: Togo
authors.affiliation: Takano Clinic, Tokyo, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Takano
authors.affiliation: Center for Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Fukui
authors.affiliation: Center for Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Ito
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D017291:Clarithromycin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005240:Feasibility Studies; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D011758:Pyrroles / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D013449:Sulfonamides / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: C552956:1-(5-(2-fluorophenyl)-1-(pyridin-3-ylsulfonyl)-1H-pyrrol-3-yl)-N-methylmethanamine; D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors; D011758:Pyrroles; D013449:Sulfonamides; D000658:Amoxicillin; D017291:Clarithromycin
keywords: Helicobacter pylori; eradication; multicenter study; proton pump inhibitors; vonoprazan