title: A Comparative Study of a New Class of Gastric Acid Suppressant Agent Named Vonoparazan versus Esomeprazole for the Eradication of Helicobacter pylori.
abstract: BACKGROUND
  Helicobacter pylori eradication rates have decreased worldwide. Gastric acid inhibition during treatment is important to eradicate these bacteria successfully. A new potassium-competitive acid blocker, vonoprazan (VPZ), has been shown to achieve high eradication rates in a previous randomized controlled trial.
  
  
  OBJECTIVE
  To determine the efficacy of VPZ for H. pylori eradication.
  
  
  METHODS
  A total of 874 patients were enrolled; 431 received esomeprazole (EPZ) and 443 received VPZ. First-line regimens contained clarithromycin (CAM) 200 mg b.i.d., amoxicillin 750 mg b.i.d., and either EPZ 20 mg b.i.d. or VPZ 20 mg b.i.d. for 7 days. Metronidazole 250 mg b.i.d. replaced CAM in the second-line regimens. The eradication of H. pylori was assessed by 13C-urea breath tests 4-8 weeks after each therapy.
  
  
  RESULTS
  The overall first-line eradication rate was 79.9% (341/427) with EPZ vs. 86.3% (377/439) with VPZ (p = 0.019). The second-line eradication rate was 83.3% (45/51) with EPZ vs. 91.1% (41/45) with VPZ (p = 0.900).
  
  
  CONCLUSIONS
  VPZ was significantly more effective than EPZ for first-line treatment. However, for second-line treatment, there was no significant difference between EPZ and VPZ.
authors.affiliation: Department of Gastroenterology and Hepatology, Saiseikai Nakatsu Hospital, Osaka, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tsujimae
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamashita
authors.forename: Hiroki
authors.initials: H
authors.lastname: Hashimura
authors.forename: Chise
authors.initials: C
authors.lastname: Kano
authors.forename: Keiko
authors.initials: K
authors.lastname: Shimoyama
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kanamori
authors.forename: Kei
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Akio
authors.initials: A
authors.lastname: Koizumi
authors.forename: Kenji
authors.initials: K
authors.lastname: Momose
authors.forename: Takaaki
authors.initials: T
authors.lastname: Eguchi
authors.forename: Takumi
authors.initials: T
authors.lastname: Fukuchi
authors.forename: Mikio
authors.initials: M
authors.lastname: Fujita
authors.forename: Akihiko
authors.initials: A
authors.lastname: Okada
mesh_terms: D000368:Aged; D000658:Amoxicillin / Q000008:administration & dosage / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D001944:Breath Tests; D017291:Clarithromycin / Q000008:administration & dosage / Q000627:therapeutic use; D060740:Disease Eradication; D004359:Drug Therapy, Combination; D064098:Esomeprazole / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D007564:Japan; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D011758:Pyrroles / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D013449:Sulfonamides / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
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; D008795:Metronidazole; D000658:Amoxicillin; D017291:Clarithromycin; D064098:Esomeprazole