Optimization of Vonoprazan--amoxicillin Dual Therapy for Eradicating Helicobacter Pyloriinfection
Status:
Not yet recruiting
Trial end date:
2024-04-20
Target enrollment:
Participant gender:
Summary
Helicobacter pylori infection is closely related to gastritis, peptic ulcer,
mucosa-associated lymphoid tissue lymphoma and gastric cancer. Eradication of HP can
significantly improve and reduce HP-related diseases. International and domestic guidelines
recommend a 10-14 day quadruple regimen containing bismuth as first-line treatment, achieving
an eradication rate of more than 80%. However, some disadvantages of these quadruple
regimens, such as severe adverse reactions, high medical costs and low compliance, prevent
their application in clinical practice. Studies at home and abroad have shown that high-dose
proton pump inhibitors combined with amoxicillin can be used as the first-line treatment for
HP eradication, with good efficacy and compliance and low rate of adverse reactions. And
because it is a single antibiotic therapy, we do not expect this regimen to increase
antibiotic resistance rates for HP. The maintenance of gastric PH > 6 is one of the key
factors for HP eradication. The acid inhibition effect of proton pump mainly depends on the
degree of individual metabolism of proton pump. Vonoprazan fumarate, a new competitive
potassium acid blocker, is not affected by gene polymorphism, and has the advantage of
stronger and longer inhibition effect on gastric acid compared with proton pump inhibitors.
In most parts of China, HP is characterized by high infection rate and antibiotic resistance
rate, requiring higher eradication rate and safety regimen.This study aimed to evaluate two
different amoxicillin dosages
(1 g b.i.d. vs. 0.75 g q.i.d.) and two different durations of therapy (14 vs.10 days) to gain
insights of the effectiveness of VA dual therapy .