Eradication rates of Helicobacter pylori in treatment‐naive patients following 14‐day vonoprazan‐amoxicillin dual therapy: A multicenter randomized controlled trial in China

作者：Jie Hu, Hao Mei, Na‐Yun Su, Wen‐jing Sun, Dekui Zhang, Lilin Fan, Ping He, Jie Pan, Xing‐wei Wang, Pei‐Ying Zou, Yu‐xiang Liu, Yan Guo, Chun‐Hui Lan · 发表于：Helicobacter · 年份：2023 · DOI：10.1111/hel.12970 · 被引用次数：54 · 研究领域：Helicobacter pylori-related gastroenterology studies、Clostridium difficile and Clostridium perfringens research、Gastrointestinal motility and disorders

BACKGROUND: Potassium-competitive acid blockers (P-CAB) are recommended for the treatment of Helicobacter pylori infections, but dual therapy of P-CAB with amoxicillin has been poorly studied. The current study compared the efficacy, adverse reactions, compliance, and effects on gut microbiota of 14-day vonoprazan-amoxicillin (VA) dual therapy with esomeprazole, bismuth potassium citrate, amoxicillin, and metronidazole (EBAM) quadruple therapy in treatment-naive patients with H. pylori. MATERIALS AND METHODS: C urea breath tests (UBT) 4-6 weeks post-treatment. Fecal samples were collected, and gut microbial populations were analyzed by 16S rDNA and metagenomic sequencing technology. RESULTS: Eradication rates of H. pylori in the VA and EBAM groups were 88.7% and 91.8%, respectively, according to intention-to-treat (ITT) analysis; 95.6% and 96.7% with per-protocol (PP) analysis; and 94.5% and 96.7% with modified ITT (mITT) analysis (all p > 0.05). The incidence of adverse reactions in the VA group was significantly lower compared to the EBAM group, and compliance within both groups was good. There was no difference in α-diversity or microbial composition in the VA and EBAM groups at one-month post-treatment compared to baseline, except for a markedly reduced abundance of Bacteroides in the EBAM group. CONCLUSION: VA therapy achieved excellent eradication rates with low adverse reactions, good compliance, and little impact on gut microbiota. VA therapy should be recommended as ...