High Efficacy of Vonoprazan—Based First—Line and Second—Line Eradication Therapy for Helicobacter pylori Infection Has Been Maintained Since 2015 in Japan

Abstract

Introduction: Vonoprazan (VPZ), a potassium—competitive acid blocker (P—CAB), has strong acid—inhibitory effects and has been used for the eradication of H. pylori since February 2015. VPZ—based eradication therapy has achieved higher eradication rate comparing with PPIs. The aim of this study was to investigate whether the efficacy of eradication therapy using VPZ remains high or reduced. Methods: Patients who received eradication therapy in Hirosaki University Hospital between February 2015 ˜ January 2016 (initial period) and February 2017 ˜ January 2018 (current period) were studied retrospectively. As the first—line therapy, patients infected with H. pylori administered VPZ (20 mg; bid) with amoxicillin (AMOX: 750 mg; bid) and clarithromycin (CAM: 200 mg; bid) for 7 days. Patients who failed first—line therapy administered metronidazole (MNZ) instead of CAM as the second—line therapy. 6—10 weeks after finishing the treatment, results of eradication therapy was assessed by either stool antigen test or 13C—UBT, which was used at the initial diagnosis of H. pylori infection. Results: A total of 113 patients who received first—line and/or second—line eradication therapy were studied. All the patients completed the regimens without major side effects. The eradication rate of first—line was 89.3% (50/56; 95% CI: 81.2—97.4%) in initial period and 86.8% (33/38; 95% CI: 76.1—97.6%) current period, respectively. On the other hand, eradication rate of second—line therapies were 100% in both initial period (14/14) and current period (8/8). Conclusion: H. pylori eradication treatments using VPZ have been safe and effective since the introduction of VPZ in February 2015.