Hiroshi Matsumoto1, Akiko Shiotani2, Ryo Katsumata1, Minoru Fujita1, Rui Nakato1, Takahisa Murao1, Manabu Ishii1, Tomoari Kamada1, Ken Haruma1, David Y Graham3. 1. Department of Internal Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki City, Okayama Prefecture, 701-0192, Japan. 2. Department of Internal Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki City, Okayama Prefecture, 701-0192, Japan. shiotani@med.kawasaki-m.ac.jp. 3. Department of Medicine, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, TX, USA.
Abstract
BACKGROUND: Vonoprazan is a novel potassium-competitive acid blocker (P-CAB) recently approved for Helicobacter pylori eradication therapy in Japan. AIMS: To compare PPI- and P-CAP-containing triple therapy and vonoprazan-based triple therapy. METHODS: Two hundred ninety-five initial subjects received a PPI-containing triple therapy; the next 125 subjects received vonoprazan-containing triple therapy. Two sequential groups received 7-day eradication regimens consisting of amoxicillin 750 mg, clarithromycin 200 mg both twice a day with standard dose PPI or vonoprazan (20 mg) each twice daily. H. pylori eradication was confirmed by a 13C-UBT. Clarithromycin susceptibility was evaluated by 23S rRNA PCR. RESULTS: Population cure rates with clarithromycin susceptible strains were 89.6 versus 100 % for PPI and vonoprazan therapies, respectively. Cure rates with resistant strains were 40.2 % with PPI therapy versus 76.1 % with vonoprazan triple therapy. There was no difference in side effects. CONCLUSIONS: Although 7-day P-CAB triple therapy was superior to 7-day PPI triple therapy, neither was highly effective, or can be recommended, in the presence of clarithromycin-resistant infections.
BACKGROUND:Vonoprazan is a novel potassium-competitive acid blocker (P-CAB) recently approved for Helicobacter pylori eradication therapy in Japan. AIMS: To compare PPI- and P-CAP-containing triple therapy and vonoprazan-based triple therapy. METHODS: Two hundred ninety-five initial subjects received a PPI-containing triple therapy; the next 125 subjects received vonoprazan-containing triple therapy. Two sequential groups received 7-day eradication regimens consisting of amoxicillin 750 mg, clarithromycin 200 mg both twice a day with standard dose PPI or vonoprazan (20 mg) each twice daily. H. pylori eradication was confirmed by a 13C-UBT. Clarithromycin susceptibility was evaluated by 23S rRNA PCR. RESULTS: Population cure rates with clarithromycin susceptible strains were 89.6 versus 100 % for PPI and vonoprazan therapies, respectively. Cure rates with resistant strains were 40.2 % with PPI therapy versus 76.1 % with vonoprazan triple therapy. There was no difference in side effects. CONCLUSIONS: Although 7-day P-CAB triple therapy was superior to 7-day PPI triple therapy, neither was highly effective, or can be recommended, in the presence of clarithromycin-resistant infections.
Authors: Ling Ren; Hong Lu; Hai Yan Li; Ling Yin Zhu; Xiao Qing Xu; Li Yang Gu; Zhi Zheng Ge; Xiao Bo Li Journal: J Dig Dis Date: 2014-11 Impact factor: 2.325
Authors: Maria Teresa Mascellino; Barbara Porowska; Massimiliano De Angelis; Alessandra Oliva Journal: Drug Des Devel Ther Date: 2017-07-28 Impact factor: 4.162