Efficacy and eradication effect of vonoprazan and high-dose amoxicillin dual therapy in CagA+VacA+ Helicobacter pylori infected patients.

Abstract

Objective: Helicobacter pylori (HP) eradication rates are higher by treated with the potassium-competitive acid blocker vonorasan than with proton pump inhibitors (PPIs). Herein, this study analyzed the clinical efficacy of vonoprazan combined with high-dose amoxicillin for dual therapy in personalized eradication of HP.

Methods: This retrospective analysis included 452 patients with type I HP who were assigned to the observation and control groups. Cytotoxin-associated gene A (CagA) and vacuolating cytotoxin A (VacA) antibodies were detected using the H. pylori antibody typing classification assay kit by Western blot. The control group underwent PPI quadruple therapy (oral administration of esomeprazole, amoxicillin, clarithromycin, and colloidal bismuth subcitrate). The observation group was treated with vonoprazan combined with high-dose amoxicillin orally. The clinical efficacy was evaluated after 14 days of treatment, and adverse reactions during treatment were compared. The eradication rates for different HP types in the two groups were detected using a ¹³C-urea breath test.

Results: There was no significant difference between the control and observation groups in sex, age, BMI, disease duration, smoking history, or drinking history. The observation group exhibited higher total effective rates and better eradication effects than the control group. The CagA⁺, VacA⁺, or CagA⁺VacA⁺ type patients showed no statistical difference in the incidence of adverse reactions, but the observation group showed a lower total incidence of adverse reactions than the control group.

Conclusion: Vonoprazan combined with high-dose amoxicillin has better clinical efficacy and eradication effect for patients with CagA⁺VacA⁺ HP, along with reduced adverse reactions.