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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Intern+Med
2017 ; 56
(11
): 1277-1285
Nephropedia Template TP
gab.com Text
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English Wikipedia
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.