Vonoprazan-based triple therapy is effective for Helicobacter pylori eradication irrespective of clarithromycin susceptibility.
Adult
Aged
Aged, 80 and over
Amoxicillin
/ administration & dosage
Anti-Bacterial Agents
/ administration & dosage
Clarithromycin
/ administration & dosage
Drug Resistance, Bacterial
Drug Therapy, Combination
Endoscopy, Digestive System
Female
Helicobacter Infections
/ drug therapy
Helicobacter pylori
/ drug effects
Humans
Male
Middle Aged
Prospective Studies
Proton Pump Inhibitors
/ administration & dosage
Pyrroles
/ administration & dosage
Sulfonamides
/ administration & dosage
Treatment Outcome
Young Adult
Clarithromycin resistance
H. pylori eradication
Triple therapy
Vonoprazan
Journal
Journal of gastroenterology
ISSN: 1435-5922
Titre abrégé: J Gastroenterol
Pays: Japan
ID NLM: 9430794
Informations de publication
Date de publication:
Nov 2020
Nov 2020
Historique:
received:
27
01
2020
accepted:
31
08
2020
pubmed:
16
9
2020
medline:
1
6
2022
entrez:
15
9
2020
Statut:
ppublish
Résumé
Helicobacter pylori causes peptic ulcers and accounts for over 90% of gastric cancers; however, eradication rates have been declining due to antimicrobial resistance. Vonoprazan (VPZ), a potassium-competitive acid blocker, produces rapid and profound gastric acid suppression and has shown promising effects in the improvement of H. pylori eradication rates. The efficacy and safety of VPZ-based triple therapy as a first-line regimen for H. pylori eradication and its relationship with clarithromycin (CAM) susceptibility were evaluated. From May 2015 to September 2017, H. pylori-infected patients who underwent esophagogastroduodenoscopy with CAM susceptibility testing were prospectively enrolled. Patients received a 7-day triple therapy regimen (VAC) of VPZ (20 mg), amoxicillin (750 mg), and CAM (200 mg) twice daily. Eradication rates, demographics, CAM susceptibility, and safety profiles were assessed. VAC was administered to 146 patients (median age: 63, range: 22-85 years) (60% of whom were females) who underwent CAM susceptibility testing, and 131 patients underwent CAM-resistant H. pylori was prevalent in one-third of patients in the Tokyo metropolitan area. VPZ-based triple therapy was highly effective and well-tolerated irrespective of CAM susceptibility. Therefore, it could be a valuable first-line treatment regimen for H. pylori infection.
Sections du résumé
BACKGROUND
BACKGROUND
Helicobacter pylori causes peptic ulcers and accounts for over 90% of gastric cancers; however, eradication rates have been declining due to antimicrobial resistance. Vonoprazan (VPZ), a potassium-competitive acid blocker, produces rapid and profound gastric acid suppression and has shown promising effects in the improvement of H. pylori eradication rates. The efficacy and safety of VPZ-based triple therapy as a first-line regimen for H. pylori eradication and its relationship with clarithromycin (CAM) susceptibility were evaluated.
METHODS
METHODS
From May 2015 to September 2017, H. pylori-infected patients who underwent esophagogastroduodenoscopy with CAM susceptibility testing were prospectively enrolled. Patients received a 7-day triple therapy regimen (VAC) of VPZ (20 mg), amoxicillin (750 mg), and CAM (200 mg) twice daily. Eradication rates, demographics, CAM susceptibility, and safety profiles were assessed.
RESULTS
RESULTS
VAC was administered to 146 patients (median age: 63, range: 22-85 years) (60% of whom were females) who underwent CAM susceptibility testing, and 131 patients underwent
CONCLUSIONS
CONCLUSIONS
CAM-resistant H. pylori was prevalent in one-third of patients in the Tokyo metropolitan area. VPZ-based triple therapy was highly effective and well-tolerated irrespective of CAM susceptibility. Therefore, it could be a valuable first-line treatment regimen for H. pylori infection.
Identifiants
pubmed: 32930864
doi: 10.1007/s00535-020-01723-6
pii: 10.1007/s00535-020-01723-6
doi:
Substances chimiques
1-(5-(2-fluorophenyl)-1-(pyridin-3-ylsulfonyl)-1H-pyrrol-3-yl)-N-methylmethanamine
0
Anti-Bacterial Agents
0
Proton Pump Inhibitors
0
Pyrroles
0
Sulfonamides
0
Amoxicillin
804826J2HU
Clarithromycin
H1250JIK0A
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1054-1061Subventions
Organisme : Takeda Pharmaceutical Company
ID : 4
Organisme : AstraZeneca
ID : 4
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