David J. Bjorkman, MD, MSPH (HSA), SM (Epid.) reviewing Suzuki S et al. Am J Gastroenterol 2016 May 17.

Eradication was greater with a triple therapy based on a potassium-competitive acid blocker than with a PPI-based triple therapy.

Standard proton-pump inhibitor (PPI)–based triple therapy for Helicobacter pylori eradication has demonstrated decreasing efficacy as antibiotic resistance increases. Investigators retrospectively compared the eradication of H. pylori in 175 propensity-score–matched pairs of patients treated in a single Japanese hospital during a 34-month period. All patients received amoxicillin 750 mg and clarithromycin 200 mg twice daily for 7 days. In addition, one group received a PPI (lansoprazole 20 mg or rabeprazole 30 mg), and another received a potassium-competitive acid blocker (P-CAB; vonoprazan 20 mg), each twice daily for 7 days. H. pylori eradication was evaluated by a breath test or stool antigen test.

The eradication rate was significantly higher in the P-CAB group compared with the PPI group in both the intention-to-treat analysis (89% vs. 71%) and the per-protocol analysis (91% vs. 72%). More skin rashes occurred in the P-CAB group, but no severe adverse effects occurred.

CITATION(S):

Suzuki S et al. The efficacy and tolerability of a triple therapy containing a potassium-competitive acid blocker compared with a 7-day PPI-based low-dose clarithromycin triple therapy. Am J Gastroenterol 2016 May 17; [e-pub]. 

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