Retrospective Cohort Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pharmacol Ther. Nov 6, 2016; 7(4): 550-555
Published online Nov 6, 2016. doi: 10.4292/wjgpt.v7.i4.550
Usefulness of vonoprazan, a potassium ion-competitive acid blocker, for primary eradication of Helicobacter pylori
Shinya Yamada, Takumi Kawakami, Yoshikazu Nakatsugawa, Takahiro Suzuki, Hideki Fujii, Naoya Tomatsuri, Hideki Nakamura, Hideki Sato, Yusuke Okuyama, Hiroyuki Kimura, Norimasa Yoshida
Shinya Yamada, Takumi Kawakami, Yoshikazu Nakatsugawa, Takahiro Suzuki, Hideki Fujii, Naoya Tomatsuri, Hideki Nakamura, Hideki Sato, Yusuke Okuyama, Hiroyuki Kimura, Norimasa Yoshida, Department of Gastroenterology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, Japan
Author contributions: Yamada S and Yoshida N contributed to study conception and design; they also contributed to writing, editing and final approval of article; Kawakami T, Nakatsugawa Y, Suzuki T, Fujii H, Tomatsuri N, Nakamura H, Sato H, Okuyama Y and Kimura H performed the research.
Institutional review board statement: The study protocol was approved by the Ethics Committee of Japanese Red Cross Kyoto Daiichi Hospital.
Informed consent statement: All study participants, or their legal guardian, provided informed verbal consent prior to study enrollment.
Conflict-of-interest statement: There is no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Shinya Yamada, Department of Gastroenterology, Japanese Red Cross Kyoto Daiichi Hospital, Hon-machi 15-749, Kyoto 605-0981, Japan. syo335@koto.kpu-m.ac.jp
Telephone: +81-75-5611121 Fax: +81-75-5616308
Received: June 15, 2016
Peer-review started: June 17, 2016
First decision: July 20, 2016
Revised: July 28, 2016
Accepted: August 27, 2016
Article in press: August 29, 2016
Published online: November 6, 2016
Abstract
AIM

To investigate usefulness of triple therapy with vonoprazan, a potassium ion-competitive acid blocker and antibiotics, for Helicobacter pylori (H. pylori) eradication.

METHODS

The H. pylori eradication rate was examined in 2507 patients (2055 undergoing primary eradication and 452 undergoing secondary eradication, excluding patients with subtotal gastrectomy) at the Japanese Red Cross Kyoto Daiichi Hospital from March 2013 to September 2015. For patients treated from March 2013 to February 2015, a proton pump inhibitor (PPI) was used to reduce acid secretion, while vonoprazan was used after March 2015. The success rates of the 2 regimens (PPI + amoxicillin + clarithromycin/metronidazole, or vonoprazan + amoxicillin + clarithromycin/metronidazole) were compared.

RESULTS

The success rate of primary H. pylori eradication was significantly higher in the vonoprazan group. When stratified by the underlying disease, a significant increase of the H. pylori eradication rate was observed in patients with chronic gastritis. A significantly lower H. pylori eradication rate was observed in younger patients compared to older patients in the PPI group, but there was no difference according to age in the vonoprazan group. On the other hand, the success rate of secondary eradication was similar at approximately 90% in both groups.

CONCLUSION

Vonoprazan is very useful for primary eradication of H. pylori, and may become a first-line acid secretion inhibitor instead of PPIs.

Keywords: Helicobacter pylori, Eradication, Vonoprazan, Chronic gastritis, Potassium ion-competitive acid blocker

Core tip: Use of vonoprazan, a potassium ion-competitive acid blocker, is expected to achieve a higher eradication rate than conventional triple therapy. The success rates of the 2 regimens (use of proton pump inhibitor vs vonoprazan) were compared. The success rate of primary Helicobacter pylori (H. pylori) eradication was significantly higher in the vonoprazan group. When stratified by the underlying disease, a significant increase of the H. pylori eradication rate was observed in patients with chronic gastritis. Vonoprazan is very useful for primary eradication of H. pylori, and may become a first-line acid secretion inhibitor instead of proton pump inhibitors.