TY - JOUR AB - Gastric acid inhibition during treatment is important for the eradication of Helicobacter pylori (H. pylori) infection. A novel potassium‑competitive acid blocker, vonoprazan (VPZ), has been demonstrated to achieve high eradication rates; however, the efficacy of second‑line treatment in failures of VPZ‑based triple therapy has not been well studied. The aim of the current study was to determine the efficacy of VPZ in a first‑line regimen for H. pylori eradication, and the efficacy of a second‑line regimen using metronidazole (MTZ) in failures with the first‑line regimen. Of 580 subjects enrolled in the study, 524 patients completed first‑line treatment (275 patients who received VPZ and 249 patients who received LPZ). First‑line regimens consisted of a combination of clarithromycin (CAM) 200 or 400 mg twice a day, amoxicillin (AMPC) 750 mg twice a day, and either LPZ 30 mg or VPZ 20 mg twice a day, administered orally for 7 days. CAM and VPZ/LPZ were replaced with metronidazole (MTZ) 250 mg and rabeprazole 10 mg in the second‑line regimens. The eradication of H. pylori was assessed by the H. pylori stool antigen test. The overall first‑line eradication rate with VPZ was significantly higher than that with LPZ [91.0% (250/275) vs. 84.7% (211/249), respectively, P=0.030]. The dose of CAM (400 vs. 800 mg) did not affect the eradication rate in either the VPZ or LPZ regimens. The overall eradication rates of the second‑line regimens with MTZ did not differ significantly between the VPZ‑failure and LPZ‑failure groups [87.0% (20/23) vs. 87.9% (29/33), respectively, P=0.700]. Therefore, VPZ was significantly more effective than LPZ for first‑line treatment. In patients with failure of first‑line eradication therapy, successful results of second‑line eradication therapy did not differ between the VPZ‑ and LPZ‑failure groups. In conclusion, VPZ‑based triple therapy should be recommended for eradication of H. pylori. AD - Department of Pharmacy, Mie Prefectural General Medical Center, Yokkaichi, Mie 510‑8561, Japan Department of Gastroenterology, Mie Prefectural General Medical Center, Yokkaichi, Mie 510‑8561, Japan AU - Mori,Naoyoshi AU - Nishiura,Yuuki AU - Suga,Daisuke AU - Moritani,Isao AU - Yamanaka,Yutaka AU - Ooya,Yumi AU - Inoue,Hidekazu AU - Takase,Koujirou AU - Hioki,Masato AU - Shiraki,Katsuya DA - 2018/08/01 DO - 10.3892/br.2018.1111 EP - 174 IS - 2 JO - Biomed Rep KW - vonoprazan lansoprazole Helicobacter pylori second‑line triple therapy clarithromycin‑resistant PY - 2018 SN - 2049-9434 2049-9442 SP - 169 ST - Second‑line triple therapy in failures with vonoprazan‑based triple therapy for eradication of Helicobacter pylori T2 - Biomedical Reports TI - Second‑line triple therapy in failures with vonoprazan‑based triple therapy for eradication of Helicobacter pylori UR - https://doi.org/10.3892/br.2018.1111 VL - 9 ER -