Efficacy of different treatment duration of vonoprazan combined with low-dose amoxicillin in Helicobacter pylori eradication
10.3760/cma.j.cn311367-20240102-00004
- VernacularTitle:不同疗程伏诺拉生联合小剂量阿莫西林根除幽门螺杆菌的疗效分析
- Author:
Yizhou JIANG
1
;
Kai MA
;
Cheng CUI
;
Xin CAO
;
Xiaoyong WANG
Author Information
1. 南京医科大学附属常州第二人民医院消化内科，常州 213003
- Keywords:
Helicobacter pylori;
Dual therapy;
Vonoprazan;
Low-dose amoxicillin;
Eradication
- From:
Chinese Journal of Digestion
2024;44(6):361-367
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy and safety of different treatment duration of dual therapy including vonoprazan and low-dose amoxicillin in Helicobacter pylori ( H. pylori) eradication. Methods:From December 1, 2022 to November 30, 2023, a total of 150 H. pylori-infected patients who underwent primary treatment in the Affiliated Changzhou No.2 People′s Hospital of Nanjing Medical University were recruited. The patients were divided into 10-day treatment group and 14-day treatment group with 75 patients in each group by random number table method. Patients of both groups were treated with vonoprazan (20 mg each time, twice per day) combined with amoxicillin (0.75 g each time, 3 times per day), and the treatment duration was 10 and 14 days, respectively. Intention-to-treat (ITT) and per-protocol (PP) analyses were used to evaluate the eradication efficacy of H. pylori of the 10-day treatment group and 14-day treatment group. PP analysis was used to compare the incidence of adverse events between the 2 groups. Cost-effectiveness analysis was performed to evaluate the economic efficiency of the 2 treatment regimens. Identified factors affecting the eradication rate in the 10-day treatment group based on the PP. Independent sample t-test and chi-square test were used for statistical analysis. Results:In ITT and PP analysis, a total of 75, 75 patients and 70, 72 patients were included in the 10-day treatment group and 14-day treatment group, respectively. The results of ITT analysis showed that the eradication rates of 10-day treatment group and 14-day treatment group were 86.7% (65/75) and 90.7% (68/75), respectively. The results of PP analysis showed that the eradication rates of the 2 groups were 92.9% (65/70) and 94.4% (68/72), respectively, and the differences were not statistically significant (both P>0.05). The results of PP analysis showed that the incidences of adverse events of the 10-day treatment group and 14-day treatment group were 12.9% (9/70) and 9.7% (7/72), respectively, and the difference was not statistically significant( P>0.05). The cost-effectiveness ratios of the 10-day treatment group and 14-day treatment group were 3.29 and 4.19 yuan/%, respectively. The optimal cut-off values were 63.5 kg for body weight and 1.73 m 2 for body surface area to affect the H. pylori eradication rate. The H. pylori eradication rate of patients with body weight ≤ 63.5 kg was higher than that of patients with body weight >63.5 kg (100.0%, 42/42 vs. 82.1%, 23/28), and the H. pylori eradication rate of the patients with body surface area≤1.73 m 2 was higher than that of patients with body surface area>1.73 m 2 (100.0%, 45/45 vs. 80.3%, 20/25), and the differences were statistically significant ( χ2=5.61 and 6.91, P=0.018 and 0.009). Conclusions:The 10-day combination therapy of vonoprazan and low-dose amoxicillin is a safe and effective primary treatment regimen for H. pylori eradication. Body weight and body surface area are influencing factors of the eradication rate.
