Success rate of helicobacter pylori eradication using vonoprazan-based triple therapy as first-line treatment at a tertiary hospital in Baguio City
- Author:
Tristan John B. Guston, MD
1
;
Maria Elizabeth T. Espiritu, MD
2
Author Information
- Publication Type:Journal Article
- Keywords: Vonoprazan; Vonoprazan-based Triple Therapy; H. pylori Eradication
- MeSH: Helicobacter pylori
- From: Philippine Journal of Internal Medicine 2023;61(2):36-44
- CountryPhilippines
- Language:English
-
Abstract:
Background:Helicobacter pylori is acknowledged to cause chronic gastritis and peptic ulcer disease and is also implicated
in gastric carcinoma and B cell mucosa-associated lymphoid tissue (MALT) lymphoma development. It has infected at least
half of the world’s population. Proton Pump Inhibitors (PPIs) have been the conventional antacid of choice for H. pylori
eradication triple therapy, while vonoprazan is a novel drug of its class that was recently studied but is limited to an oral
form which makes it less feasible in cases of acute gastrointestinal bleeding. According to several systematic reviews and
meta-analyses, the vonoprazan-based triple therapy regimen for H. pylori eradication is a non-inferior treatment to
traditional PPI-based treatment when given in 1 week for patients having no active gastrointestinal bleeding. Likewise, a
safety profile has been established with its use, offering an alternative treatment option.
Objectives:The research aims to identify the H. pylori eradication rate among H. pylori-positive patients who received a vonoprazan-based triple therapy regimen as outpatients, describe their clinicodemographic profile, and identify potential side effects associated with the treatment.
Methods:This study utilized a cross-sectional study design in a single tertiary institution from January 2018 to December 2020. Descriptive and inferential statistics were used in data analysis. Frequency and percentage were utilized to determine the success and failure rates of H. pylori eradication, describe the clinicodemographic profile of patients who underwent vonoprazan-based triple therapy, and the potential side effects with treatment. The chi-square test of independence was applied to assess the significant difference in the successful and failed eradication rates across the clinicodemographic profile. A P-value of <0.05 was considered statistically significant, and statistical analyses were conducted using SPSS version 20.0.
Results:32 (91%) had successful H. pylori eradication, with the majority of them determined by a negative 13C-UBT result (62.8%) and the rest with a negative H. pylori stool antigen test (28.6%). The majority of patients undergoing H. pylori eradication using a vonoprazan-based regimen with documented successful eradication belonged to the 19 to 39 years old group (50%), clerical support workers (40.63%), with a chief complaint of abdominal pain (46.88%), with no known co- morbid illness (75%), and with endoscopic finding limited to antral gastritis alone (46.88%). This study described only two documented side effects of treatment: diarrhea and abdominal pain (2.9%).
Conclusion:Vonoprazan-based triple therapy, given at 20 mg twice daily for 7 days, has shown a high H. pylori eradication rate among hemodynamically stable patients, without active bleeding, and treated on an outpatient basis. There was a significant difference in eradication success and failure across co-morbidities, with a higher success rate in those without co-morbid illness. A high success rate was also seen in patients <40 years of age, with a single chief complaint, and with antral gastritis as the sole endoscopic finding. - Full text:PJIM 21.pdf
