Vonoprazan-containing Dual and Triple Therapies are Non-inferior to Bismuth-quadruple Therapy for Helicobacter pylori Eradication: A Single-center, Prospective, Open-label, Real-World Study

作者：Ya‐Bin Qi, Xiao-Ting Li, Qiao‐Qiao Shao, Lu Xu, Wenjing Zhang, Shushu Song, Qin Yan, Shiyu Shi, Ruo‐Bing Hu, Amr Mekky, Chen Zhang, Jing Ma, Wei Xiao, Kuan Li, Tingting Liu, Xinhui Fang, Lida Zhang, Guo-Hong Yang, Songze Ding · 发表于：Journal of Gastrointestinal and Liver Diseases · 年份：2025 · DOI：10.15403/jgld-6183 · 被引用次数：5 · 研究领域：Helicobacter pylori-related gastroenterology studies、Gastric Cancer Management and Outcomes、Esophageal Cancer Research and Treatment

BACKGROUND AND AIMS: Vonoprazan (Vo) and amoxicillin (Amx) dual therapy has shown promising results for Helicobacter pylori (H. pylori) eradication. However, its efficacy needs to be verified in an area with a high prevalence of both H. pylori and gastric cancer. It is also unknown if the modified Vo-Amx plus bismuth (Bis) regimen might increase the eradication rate. We aimed to investigate the efficacy and safety of Vo-Amx and Vo-Amx-Bis regimens, compared to bismuth-containing quadruple therapy (BQT) for H. pylori eradication, as well as factors that affect the curing rate. METHODS: A total of 342 treatment-naïve H. pylori-infected patients were screened and 255 were enrolled and randomized into Vo-Amx, Vo-Amx-Bis, and BQT groups for treatment. H. pylori infection status was determined by 13C-urea breath test. The eradication rate and incidence of adverse events were assessed, and factors that might affect the curing rate were also analyzed. RESULTS: In per-protocol (PP) analysis, H. pylori eradication rates in Vo-Amx, Vo-Amx-Bis, and BQT groups were 95.1%, 92.7%, and 90.4%, respectively (p>0.05). In intention-to-treat (ITT) analysis, eradication rates in Vo-Amx, Vo-Amx-Bis, and BQT groups were 91.8%, 89.4%, and 88.2%, respectively (p>0.05). The eradication efficacy of Vo-Amx and Vo-Amx-Bis groups was non-inferior to that of BQT group, and the incidence of side effects (including nausea, vomiting, anorexia, abdominal pain, diarrhea, palpitation, dizziness, and debilitation)...