title: Vonoprazan-Based Regimen Is More Useful than PPI-Based One as a First-LineHelicobacter pyloriEradication: A Randomized Controlled Trial.
abstract: Background. A new agent, potassium-competitive acid blocker vonoprazan (VPZ) has potent acid-inhibitory effects and may offer advantages over conventionalH. pylorieradication therapies. We aimed to compare the eradication rate between VPZ-based treatment and PPI-based one.Methods. This randomized controlled trial was designed to assign 141 patients withH. pylori-positive gastritis to VPZ group (VPZ 20 mg, amoxicillin 750 mg, and clarithromycin 200 or 400 mg twice daily for 7 days) or PPI group (rabeprazole 20 mg or lansoprazole 30 mg, amoxicillin 750 mg, and clarithromycin 200 or 400 mg twice daily for 7 days). Primary endpoints were eradication rates and adverse events.Results. Seventy of 72 patients in VPZ group and 63 of 69 patients in PPI group completed the treatment after 7 days. The eradication rate was significantly higher in VPZ group than PPI group by intention-to-treat analysis (95.8% versus 69.6%,P= 0.00003, 95% confidence interval [CI] 88.3-99.1% versus 57.3-80.1%) and per-protocol analysis (95.7% versus 71.4%,P= 0.0002, 95% CI 88.0-99.1% versus 58.7-82.1%). The incidence of adverse events was not different between the groups (26.3% in VPZ group versus 37.7% in PPI group,P= 0.15).Conclusion. VPZ-based regimen is more useful than that PPI-based regimen as a first-lineH. pylorieradication therapy.
authors.affiliation: Department of Gastroenterology, Nagano Red Cross Hospital, Nagano, Japan.
authors.forename: Masafumi
authors.identifier: 0000-0002-0381-200X
authors.initials: M
authors.lastname: Maruyama
authors.affiliation: Department of Metabolic Regulation, Shinshu University Graduate School of Medicine, Matsumoto, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Tanaka
authors.affiliation: Department of Gastroenterology, Nagano Red Cross Hospital, Nagano, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kubota
authors.affiliation: Department of Gastroenterology, Nagano Red Cross Hospital, Nagano, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Miyajima
authors.affiliation: Department of Gastroenterology, Nagano Red Cross Hospital, Nagano, Japan.
authors.forename: Takefumi
authors.identifier: 0000-0002-1481-1029
authors.initials: T
authors.lastname: Kimura
authors.affiliation: Department of Gastroenterology, Nagano Red Cross Hospital, Nagano, Japan.
authors.forename: Koujiro
authors.initials: K
authors.lastname: Tokutake
authors.affiliation: Department of Gastroenterology, Nagano Red Cross Hospital, Nagano, Japan.
authors.forename: Ryujiro
authors.initials: R
authors.lastname: Imai
authors.affiliation: Department of Gastroenterology, Nagano Red Cross Hospital, Nagano, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Fujisawa
authors.affiliation: Department of Gastroenterology, Nagano Red Cross Hospital, Nagano, Japan.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Mori
authors.affiliation: Department of Gastroenterology, Nagano Red Cross Hospital, Nagano, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Matsuda
authors.affiliation: Department of Gastroenterology, Nagano Red Cross Hospital, Nagano, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Wada
authors.affiliation: Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Horiuchi
authors.affiliation: Department of Gastroenterology, Aizawa Hospital, Matsumoto, Japan.
authors.forename: Kendo
authors.initials: K
authors.lastname: Kiyosawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017291:Clarithromycin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects; D006801:Humans; D007564:Japan; D064747:Lansoprazole / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D011758:Pyrroles / Q000627:therapeutic use*; D064750:Rabeprazole / Q000627:therapeutic use; D016037:Single-Blind Method; D013449:Sulfonamides / 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; D054328:Proton Pump Inhibitors; D011758:Pyrroles; D013449:Sulfonamides; D064747:Lansoprazole; D064750:Rabeprazole; D000658:Amoxicillin; D017291:Clarithromycin