Vonoprazan versus conventional proton pump inhibitor-based triple therapy as first-line treatment against Helicobacter pylori: A multicenter retrospective study in clinical practice

Abstract

Aim

Vonoprazan is a potassium-competitive acid blocker, a new type of acid-suppressing drug, and has recently become available for peptic ulcers, gastroesophageal reflux disease, and Helicobacter pylori (H. pylori) eradication. Its efficacy for H. pylori eradication therapy isreported in a phase III randomized controlled trial, and in a single center study. However, the evidence for its efficacy and feasibility is still limited.

Material and Methods

We performed a multicenter retrospective study of patients who received first-line H. pylori eradication therapy between Mar 2013 and Nov 2015. We compared the feasibility and effectiveness of vonoprazan-based triple therapy versus conventional PPI-based triple therapy.

Results

A total of 2715 patients (63.0 ± 12.1 years, 1412 [52%] males) were analyzed. Eradication rates were 87.2% (368 of 422) for vonoprazan-based therapy and 72.4% (1661 of 2293) for conventional PPI-based therapy (p < 0.01, chi-square test). Among the former group, there were 10 cases of diarrhea, 6 of nausea/vomiting, and 5 of rash, but the rates of these adverse events were not higher than those in the conventional PPI group.

Conclusion

Vonoprazan-based triple therapy is feasible; it showed a higher eradication rate than conventional PPIs as a first-line regimen.

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