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Comparative study: Vonoprazan and proton pump inhibitors in Helicobacter pylori eradication therapy

2017; Baishideng Publishing Group; Volume: 23; Issue: 4 Linguagem: Inglês

10.3748/wjg.v23.i4.668

2219-2840

Kouichi Sakurai, Hiroko Suda, Yumi Ido, Takayuki Takeichi, Ayako Okuda, Kiwamu Hasuda, Masahiro Hattori,

Gastric Cancer Management and Outcomes

AIMTo compare the effectiveness and safety of vonoprazan-based therapy with proton pump inhibitor (PPI)based therapies to treat Helicobacter pylori (H.pylori ). METHODSWe retrospectively analysed data from first-line (vonoprazan or PPI with 200 mg clarithromycin and 750 mg amoxicillin twice daily for 7 d) (n = 1353) and second-line (vonoprazan or PPI with 250 mg metronidazole and 750 mg amoxicillin twice daily for 7 d) (n = 261) eradication treatments for H. pylori positive patients with associated gastrointestinal diseases from April 2014 to December 2015 at Hattori Clinic, Japan.The primary endpoint was the eradication rate, which was assessed with a full analysis set.The secondary endpoints were adverse events and related factors. RESULTSAfter the first-line treatments, the eradication rates for vonoprazan, esomeprazol, rabeprazole, and lansoprazole were 87.9% (95%CI: 84.9%-90.5%),71.6% (95%CI: 67.5%-75.5%),62.9% (95%CI: 52.0%-72.9%),and 57.3% (95%CI: 50.4%-64.1%),respectively.The vonoprazan eradication rate was significantly higher than that of the PPIs (P < 0.01).Interestingly, smoking did not affect the H. pylori eradication rate in the vonoprazan group (P = 0.34), whereas it decreased the rates in the PPI groups (P = 0.013).The incidence of adverse events in the vonop-