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Canadian Journal of Gastroenterology and Hepatology
Volume 2017, Article ID 4385161, 7 pages
https://doi.org/10.1155/2017/4385161
Clinical Study

Vonoprazan-Based Regimen Is More Useful than PPI-Based One as a First-Line Helicobacter pylori Eradication: A Randomized Controlled Trial

1Department of Gastroenterology, Nagano Red Cross Hospital, Nagano, Japan
2Department of Metabolic Regulation, Shinshu University Graduate School of Medicine, Matsumoto, Japan
3Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan
4Department of Gastroenterology, Aizawa Hospital, Matsumoto, Japan

Correspondence should be addressed to Masafumi Maruyama; pj.ro.crj.dem-onagan@amayuram.m

Received 27 October 2016; Accepted 18 January 2017; Published 28 February 2017

Academic Editor: Michael Beyak

Copyright © 2017 Masafumi Maruyama et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. A new agent, potassium-competitive acid blocker vonoprazan (VPZ) has potent acid-inhibitory effects and may offer advantages over conventional H. pylori eradication therapies. We aimed to compare the eradication rate between VPZ-based treatment and PPI-based one. Methods. This randomized controlled trial was designed to assign 141 patients with H. pylori-positive gastritis to VPZ group (VPZ 20 mg, amoxicillin 750 mg, and clarithromycin 200 or 400 mg twice daily for 7 days) or PPI group (rabeprazole 20 mg or lansoprazole 30 mg, amoxicillin 750 mg, and clarithromycin 200 or 400 mg twice daily for 7 days). Primary endpoints were eradication rates and adverse events. Results. Seventy of 72 patients in VPZ group and 63 of 69 patients in PPI group completed the treatment after 7 days. The eradication rate was significantly higher in VPZ group than PPI group by intention-to-treat analysis (95.8% versus 69.6%, , 95% confidence interval [CI] 88.3-99.1% versus 57.3-80.1%) and per-protocol analysis (95.7% versus 71.4%, , 95% CI 88.0-99.1% versus 58.7-82.1%). The incidence of adverse events was not different between the groups (26.3% in VPZ group versus 37.7% in PPI group, ). Conclusion. VPZ-based regimen is more useful than that PPI-based regimen as a first-line H. pylori eradication therapy.