Page 7 - JCTR-10-6

Journal of Clinical and Translational Research 2024; 10(6): 317-324

Journal of Clinical and Translational Research

Journal homepage: http://www.jctres.com/en/home

ORIGINAL ARTICLE

Efficacy and safety of vonoprazan as a component of the first- and

second-line eradication regimens for Helicobacter pylori: a real-life

Egyptian study

Abdelfattah Hanno , Magdy El-Dahshan , Tarek Youssef , Ali Farag , Hussein Elamin , Magdi Hamed ,
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Sherief Abdel-Salam , Ehab Abdelatty , Eman Abdelsameea *, Yasser Fouad , Shamardan Ezz-Eldin ,
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Waleed A. Abd El Dayem , Ebada Said , Mohamed S. Ahmed 1
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1 Department of Tropical Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt, Department of Internal Medicine,
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Hepatogastroenterology Unit, Faculty of Medicine, Al-Azhar University, Cairo, Egypt, Department of Internal Medicine and
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Hepatogastroenterology, Faculty of Medicine, Ain Shams University, Cairo, Egypt, Department of Internal Medicine, Gastroenterology
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Unit, Faculty of Medicine, Cairo University, Cairo, Egypt, Department of Internal Medicine, Gastroenterology Unit, Faculty of Medicine,
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Assiut University, Assiut, Egypt, Department of Hepatogastroenterology, Faculty of Medicine, Mansoura University, Mansoura, Egypt,
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7 Department Internal Medicine, Gastroenterology Unit, Faculty of Medicine, Tanta University, Gharbia, Egypt, Department of Internal
Medicine, Hepatology and Gastroenterology Unit, Faculty of Medicine, Menofia University, Menofia, Egypt, Department of Hepatology and
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Gastroenterology, National Liver Institute, Menoufia University, Shebin El-Kom, Egypt, Department of Tropical Medicine, Faculty of Medicine,
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Minia University, Minia, Egypt, Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, South Vally University, Qena,
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Egypt, Hepatogastroenterology and Infectious Disease Department, Faculty of Medicine, Zagazig University, Sharkia, Egypt, Department of
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Hepatology, Gastroenterology and Infectious Diseases, Benha University, Qalyubia, Egypt
ARTICLE INFO ABSTRACT
Article history: Background: Vonoprazan, a new potassium competitive acid blocker, offers a rapid onset of action
Received: July 13, 2024 and a predictable antisecretory profile that is independent of the CYP2C19 genotype or parietal cell
Accepted: October 25, 2024 activity. This profile may enhance Helicobacter pylori eradication therapy.
Published Online: November 26, 2024 Aim: This research compared vonoprazan and proton-pump inhibitors (PPI) in Egypt’s first- and
second-line H. pylori eradication regimens for effectiveness, safety, and tolerability.
Keywords: Methods: A prospective, controlled, multicenter, parallel-assignment, and open-label study was
Vonoprazan designed to verify the superiority of vonoprazan versus PPI in first-line therapy (with amoxicillin
Proton-pump inhibitor and clarithromycin) or second-line therapy (with levofloxacin, doxycycline, and nitazoxanide)
Helicobacter pylori for H. pylori eradication. Patients received either vonoprazan- or PPI-based regimens for 14 days
followed by a 4-week follow-up period. The primary efficacy endpoint is the rate of first-line
*Corresponding author: eradication, while the secondary endpoint is the rate of second-line eradication among individuals
Eman Abdelsameea who did not respond to first-line treatment. Safety and tolerability of both first- and second-line
Department of Hepatology and treatments were also assessed.
Gastroenterology, National Liver Institute, Results: Of the 1184 patients allocated to the study, 701 naïve patients received first-line therapy
Menoufia University, Shebin El-Kom, Egypt. (355 patients received a triple vonoprazan-based regimen; 346 patients received triple PPI-based
Email: eabdelsameea@liver-eg.org regimen), and 483 experienced patients received the second-line therapy (243 patients received
quadrable vonoprazan-based regimen and 240 patients received quadrable PPI-based regimen).
© 2024 Author(s). This is an Open- The first-line eradication rate was 91% in vonoprazan triple therapy versus 74.6% in PPI triple
Access article distributed under the terms therapy (P < 0.001). The second-line eradication rate was 89.7% in vonoprazan quadrable therapy
of the Creative Commons Attribution- versus 78.3% in PPI quadrable therapy (P < 0.001). Both first- and second-line therapies were well
Noncommercial License, permitting all
non-commercial use, distribution, and tolerated with no remarkable adverse events or safety outcomes.
reproduction in any medium, provided the Conclusion: In both naive and experienced patients, vonoprazan-based treatment was statistically
original work is properly cited. and substantially superior to omeprazole-based therapy in eradicating H. pylori.
Relevance for Patients: This work offers a promising approach for the treatment of Egyptian
patients with H. pylori infection.
DOI: http://doi.org/10.36922/jctr.24.00043