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Efficacy of Vonoprazan-Based Triple Therapy for Helicobacter pylori Eradication: A Multicenter Study and a Review of the Literature

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Abstract

Background

Eradication therapies for Helicobacter pylori infection are advancing as new acid inhibitory reagents approved. The aim of this study was to assess the efficacy and safety of vonoprazan-based triple treatment.

Materials and Methods

Triple therapy with vonoprazan and two antibiotics (amoxicillin and clarithromycin or metronidazole) received focus in this analysis. We performed a multicenter retrospective study of patients who received vonoprazan-based eradication therapy between February 2015 and February 2016 and conducted a review of the literature.

Results

The eradication rate among the 799 patients in our multicenter study was 94.4% (95% confidence interval [CI] 92.6–96.2%) in the per-protocol analysis for first-line treatment (with vonoprazan 20 mg, amoxicillin 750 mg, and clarithromycin 200 or 400 mg, twice a day for 7 days) and 97.1% (95% CI 93.0–101.1%) for second-line treatment (with vonoprazan 20 mg, amoxicillin 750 mg, and metronidazole 250 mg, twice a day for 7 days). The overall incidence of adverse events was 4.4% in an intention-to-treat analysis with no patients hospitalized. In a literature review, six reports, in which 1380 patients received vonoprazan-based first-line eradication therapy, were included and were all reported by Japanese researchers. The eradication success rates in per-protocol analysis were between 85 and 93%, which was roughly the same among the studies.

Conclusions

Vonoprazan-based triple therapy was effective and safe for Helicobacter pylori eradication in real-world experience, confirmed by a multicenter study and a review of the pertinent literature.

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Authors and Affiliations

  1. Department of Gastroenterology, Asahikawa Kousei Hospital, 111-3 1-Jodori 24-chome, Asahikawa, Hokkaido, 078-8211, Japan

    Hiroki Tanabe, Takahiro Ito, Mitsuru Goto, Tomonobu Sato, Akihiro Fujinaga, Toru Kawamoto, Tatsuya Utsumi & Nobuyuki Yanagawa

  2. Department of Gastroenterology, International University of Health and Welfare Hospital, Tokyo, Japan

    Hiroki Tanabe, Katsuyoshi Ando, Kiichi Sato, Eiichiro Ichiishi, Takaaki Otake & Yutaka Kohgo

  3. Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Sapporo, Japan

    Katsuyoshi Ando, Yoshiki Nomura, Nobuhiro Ueno, Shin Kashima, Kentaro Moriichi, Mikihiro Fujiya & Toshikatsu Okumura

  4. Hokkaido Cancer Society, Asahikawa, Japan

    Nobuhiro Ueno & Hiroko Sugano

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  1. Hiroki Tanabe
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  2. Katsuyoshi Ando
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  20. Toshikatsu Okumura
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Correspondence to Hiroki Tanabe.

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Tanabe, H., Ando, K., Sato, K. et al. Efficacy of Vonoprazan-Based Triple Therapy for Helicobacter pylori Eradication: A Multicenter Study and a Review of the Literature. Dig Dis Sci 62, 3069–3076 (2017). https://doi.org/10.1007/s10620-017-4664-1

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