Dual Therapy of Vonoprazan and Amoxicillin for Initial Treatment of Helicobacter pylori Infection
10.3969/j.issn.1008-7125.2024.10.008
- VernacularTitle:伏诺拉生联合阿莫西林二联方案初始根除幽门螺杆菌的疗效分析
- Author:
Qiuxia YANG
1
;
Zhuo HOU
1
;
Qiuye ZHOU
1
;
Rong ZHANG
1
;
Hongping JIA
1
;
Ying YAO
1
Author Information
1. 昆明医科大学附属延安医院消化内科(650000)
- Publication Type:Journal Article
- Keywords:
Vonoprazan;
Helicobacter pylori;
Dual Therapy
- From:
Chinese Journal of Gastroenterology
2024;29(10):621-624
- CountryChina
- Language:Chinese
-
Abstract:
Background:A large number of studies have confirmed that the combination therapy of high-dose proton pump inhibitor(PPI)and amoxicillin has a good efficacy for eradication of Helicobacter pylori(Hp).As a new high-efficiency acid inhibitor,vonoprazan is expected to improve the efficacy of Hp eradication and has a good application prospect.Aims:To compare the efficacy and safety of the dual therapy of vonoprazan-amoxicillin and bismuth-containing quadruple therapy,so as to provide new treatment idea and choice for Hp eradication therapy.Methods:This is a single-center,prospective,randomized controlled clinical trial.Two hundred and ten patients positive for Hp infection and naive to eradication therapy were recruited consecutively and randomly divided into two groups.One group received dual therapy of vonoprazan-amoxicillin:vonoprazan 20 mg bid and amoxicillin 1 g tid for 14 days;the other group received bismuth-containing quadruple therapy:rabeprazole 20 mg bid,potassium bismuth citrate 600 mg bid,clarithromycin 500 mg bid,and amoxicillin 1 g bid for 14 days.After 4-6 weeks of treatment completion,the Hp eradication rate(primary outcome)was evaluated by 14C-urea breath test.Safety and compliance(secondary outcomes)were also observed and recorded in the treatment course.Results:In intention-to-treat(ITT)analysis,the Hp eradication rate of dual therapy of vonoprazan-amoxicillin was 89.6%,and that of bismuth-containing quadruple therapy was 92.3%(P＞0.05).In per-protocol(PP)analysis,the eradication rates of these two groups were 90.5%and 94.1%,respectively(P＞0.05).The adverse events rate of dual therapy was significantly lower than that of the quadruple therapy(5.7%vs.20.2%,P＜0.05).Conclusions:The efficacy of 14-day dual therapy of vonoprazan-amoxicillin for initial eradication of Hp is equal to bismuth-containing quadruple therapy,with fewer adverse events and simpler medications.It can be considered as the first-line treatment scheme of empirical treatment of Hp infection.
