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10.2169/internalmedicine.56.7833

http://scihub22266oqcxt.onion/10.2169/internalmedicine.56.7833
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suck abstract from ncbi


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pmid28566587
      Intern+Med 2017 ; 56 (11 ): 1277-1285
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  • The Superiority of Vonoprazan-based First-line Triple Therapy with Clarithromycin: A Prospective Multi-center Cohort Study on Helicobacter pylori Eradication #MMPMID28566587
  • Sue S ; Kuwashima H ; Iwata Y ; Oka H ; Arima I ; Fukuchi T ; Sanga K ; Inokuchi Y ; Ishii Y ; Kanno M ; Terada M ; Amano H ; Naito M ; Iwase S ; Okazaki H ; Komatsu K ; Kokawa A ; Kawana I ; Morimoto M ; Saito T ; Kunishi Y ; Ikeda A ; Takahashi D ; Miwa H ; Sasaki T ; Tamura T ; Kondo M ; Shibata W ; Maeda S
  • Intern Med 2017[]; 56 (11 ): 1277-1285 PMID28566587 show ga
  • Objective We evaluated the safety and efficacy of vonoprazan-based amoxicillin and clarithromycin 7-day triple therapy (VAC) in comparison to proton pump inhibitor (PPI)-based (PAC) as a first-line treatment and vonoprazan-based amoxicillin and metronidazole 7-day triple therapy (VAM) in comparison to PPI-based (PAM) as a second-line treatment for the eradication of Helicobacter pylori in Japan. Methods We performed a non-randomized, multi-center, parallel-group study to compare first-line VAC to PAC and second-line VAM to PAM. A pre-planned subgroup analysis on CAM resistance was also performed. Safety was evaluated with an adverse effects questionnaire (AEQ), which was completed by patients during therapy. Results The first-line eradication rates (ER) in the intention-to-treat (ITT) and per protocol (PP) analyses were 84.9% (95% CI: 81.9-87.6%, n=623) and 86.4% (83.5-89.1%, n=612), respectively, for VAC and 78.8% (75.3-82.0%, n=608) and 79.4% (76.0-82.6%, n=603), respectively, for PAC. The ER of VAC was higher than that of PAC in the ITT (p=0.0061) and PP analyses (p=0.0013). The ERs for VAC in patients with CAM-resistant and CAM-susceptible bacteria were 73.2% (59.7-84.2%, n=56) and 88.9% (83.4-93.1%, n=180), respectively. PAC was associated with higher AEQ scores for diarrhea, nausea, headache, and general malaise. In the second-line ITT and PP analyses VAM achieved ERs of 80.5% (74.6-85.6%, n=216) and 82.4% (76.6-87.3%, n=211), respectively, while PAM achieved ERs of 81.5% (74.2-87.4%, n=146) and 82.1% (74.8-87.9%, n=145), respectively. No significant differences were observed in the ITT (p=0.89) or PP (p=1.0) analyses. Conclusion The ER of first-line VAC was higher than that of PAC, but still <90%. No difference was observed between second-line VAM and PAM. Vonoprazan-based triple therapy was safe and well tolerated.
  • |Adult [MESH]
  • |Aged [MESH]
  • |Aged, 80 and over [MESH]
  • |Amoxicillin/*therapeutic use [MESH]
  • |Anti-Bacterial Agents/*therapeutic use [MESH]
  • |Clarithromycin/*therapeutic use [MESH]
  • |Cohort Studies [MESH]
  • |Drug Therapy, Combination [MESH]
  • |Female [MESH]
  • |Helicobacter Infections/*drug therapy [MESH]
  • |Helicobacter pylori/*drug effects [MESH]
  • |Humans [MESH]
  • |Japan [MESH]
  • |Male [MESH]
  • |Middle Aged [MESH]
  • |Prospective Studies [MESH]
  • |Proton Pump Inhibitors/*therapeutic use [MESH]
  • |Pyrroles/*therapeutic use [MESH]
  • |Sulfonamides/*therapeutic use [MESH]


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