Vonoprazan-Based versus Esomeprazole-Based Triple Therapy for Helicobacter Pylori: A Randomized Trial

Author(s): Yasser A. Abdelghani, Mahmoud M. Moussa

Background: The anti-acid effects of vonoprazan, a potassium-competitive acid blocker, are stronger and more long-lasting than those of proton pump inhibitors.

Objective: This study aimed to evaluate the efficacy of vonoprazan against esomeprazole for eradicating Helicobacter Pylori (H. pylori) for 14 days.

Patients and Methods: This randomized clinical experiment was conducted in a hospital affiliated with Minia University. Those who tested positive for having an active H. pylori infection, whether or not they had previously been treated, were split into two groups and given either VAL (vonoprazan 20 mg bid, amoxicillin 1000 mg bid, plus levofloxacin 500 mg once a day) or EAL (Esomeprazole 20 mg bid., amoxicillin 1000 mg bid, and levofloxacin 500 mg once a day). An H. pylori antigen test was performed 4–6 weeks after treatment ended to assess clearance.

Results: 122 people (61 in VAL and 61 in EAL) were split evenly between the two groups. H. pylori eradication rates were significantly higher (P = 0.031) in the VAL group compared to the EAL group. Adverse treatment-related occurrences were minor and not significantly different between the two groups.

Conclusions: The VAL regimen was effective in increasing eradication rates and was well tolerated; hence, it may be considered a potent regimen for treating H. pylori, especially in countries with high levels of antibiotic resistance.