Scandinavian Journal of Gastroenterology最新文献

{"title":"Comparing budesonide treatment in eosinophilic esophagitis: a specialized center cohort versus a population-based cohort.","authors":"Line Tegtmeier Frandsen, Katrine Krogh Sørensen, Lasse Ellingsøe Vistisen, Laura Gruchot Olandersen, Mathilde Laustsen, Mette Norstrand Bang, Dorte Melgaard, Anne Lund Krarup","doi":"10.1080/00365521.2024.2419060","DOIUrl":"10.1080/00365521.2024.2419060","url":null,"abstract":"<p><strong>Objective: </strong>Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease. The budesonide orodispersible tablet (BOT) is recommended as second-line treatment according to the Danish guideline. This study aimed to compare potential treatment disparities before BOT initiation, follow-up practices, clinico-histologic remission rates during BOT treatment, and adherence to the national guideline between the highly specialized EoE-Cph cohort and the population-based DanEoE cohort.</p><p><strong>Material and methods: </strong>This cohort study compared 65 adult patients from the EoE-Cph cohort with 65 patients from the DanEoE cohort. All patients were diagnosed between 2015-2021. The diagnosis of EoE was defined according to the AGREE consensus. Data were extracted manually from medical records and registries.</p><p><strong>Results: </strong>In the EoE-Cph cohort, 88% were prescribed proton pump inhibitors (PPIs) before started on BOT compared to 100% in the DanEoE cohort (p = 0.0035). Symptomatic follow-up occurred in 89% of EoE-Cph patients compared to 97% of DanEoE patients after BOT treatment (p = 0.0841). No difference was found between patients who underwent histologic follow-up after topical steroid treatment (83% versus 82%, p = 0.8162). Complete clinico-histologic remission was frequently observed, and no significant difference was observed between the two cohorts (67% versus 80%, p =0.1789). One out of four patients had conflicting symptomatic and histological responses.</p><p><strong>Conclusions: </strong>This study did not provide conclusive evidence favoring the treatment of EoE patients exclusively at highly specialized EoE centers. However, the authors acknowledge that further evidence is necessary before considering changes in clinical practice. Conflicting treatment responses, and discontinuation of treatment due to side effects remains a notable concern.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1265-1271"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142507033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reasons for reduced reproduction after colectomy in women with ulcerative colitis.","authors":"Emma Druvefors, Kalle Landerholm, Roland E Andersson, Gunilla Sydsjö, Pär Myrelid","doi":"10.1080/00365521.2024.2416005","DOIUrl":"10.1080/00365521.2024.2416005","url":null,"abstract":"<p><strong>Objectives: </strong>Colectomy and subsequent bowel reconstruction in women with ulcerative colitis (UC) is associated with decreased fertility, this survey aims to investigate possible reasons for this.</p><p><strong>Material and methods: </strong>Women with UC aged 18-44 years at colectomy 2000-2020 were identified and data were retrieved from the Swedish inflammatory bowel disease register (SWIBREG). Additional information was obtained using a study-specific questionnaire.</p><p><strong>Results: </strong>The survey was completed by 214 (72.8%) out of 294 eligible women. Mean age at disease onset was 22.9 years (standard deviation 0.5). No reconstruction was made in 67 (31.3%) women, whereof 24 (35.8%) had a completion proctectomy. Reconstruction was performed with ileorectal anastomosis (IRA) in 66 (30.8%) women and ileal pouch anal anastomosis (IPAA) in 81 (37.9%). Included women had on average 1.67 children (95% confidence interval 1.53-1.81) at the end of follow-up. The desire to have children was negatively affected by disease onset (59.4%), colectomy (44.9%) and reconstruction (36.7%). Altogether, 39.4% estimated that they had fewer children and 9.5% restrained completely from having children because of the disease. Difficulties to conceive were reported by 36.5% including 18.9% who expressed that they could not conceive at all. Difficulties to conceive was more common after reconstruction with IPAA (Odds Ratio [OR] 5.54) than IRA (OR 2.57).</p><p><strong>Conclusions: </strong>A majority of women with UC and colectomy expressed that the disease affected their desire to have children, more often limiting the number of children than completely refraining. For childless patients, difficulties to conceive was more common than voluntary childlessness.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1289-1296"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pyloric index, a new parameter: predicting perioperative prognosis in neonates with hypertrophic pyloric stenosis.","authors":"Başak Kaya, Hasan Akduman, Dilek Dilli, Cem Geyik, Ayşe Karaman, Özlem Balcı, Hasibe Gökçe Çınar, Nurdan Dinlen Fettah, Ayşegül Zenciroğlu","doi":"10.1080/00365521.2024.2425982","DOIUrl":"10.1080/00365521.2024.2425982","url":null,"abstract":"<p><strong>Purpose: </strong>Delays in the diagnosis and treatment of infantile hypertrophic pyloric stenosis (IHPS) may lead to laboratory and clinical decompensation in infants. The aim of this study was to determine whether pyloric measurement parameters can be effectively used in the clinical prognosis of IHPS by evaluating the relationship between pyloric dimensions on ultrasonographic evaluation at the time of presentation and clinical and laboratory parameters in infants with pyloric stenosis.</p><p><strong>Methods: </strong>A retrospective observational study was conducted on 122 infants who were followed up with the diagnosis of IHPS in our neonatal clinic and operated on by a pediatric surgeon between January 2005 and December 2020.</p><p><strong>Results: </strong>The mean pyloric dimensions of the infants were pyloric length 20 mm (17-22), pyloric thickness 5 mm (4-5.8), and pyloric index 96.5 (72.2-124). Babies with preoperative laboratory values of hypokalemia, hypochloremia and metabolic alkalosis had statistically higher pyloric thickness >5 mm (4.1-6) and pyloric index >100 (86-130) parameters.</p><p><strong>Conclusion: </strong>Pyloric thickness and pyloric index parameters can predict clinical prognosis in babies diagnosed with IHPS in the perioperative period.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1272-1276"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High neutrophil-to-lymphocyte ratio at <i>Helicobacter pylori</i> eradication increases the risk of eradication failure and post-eradication gastric cancer.","authors":"Takeshi Yasuda, Nobuaki Yagi, Tatsushi Omatsu, Hiroaki Kitae, Yuki Nakahata, Yuriko Yasuda, Naoyuki Sakamoto, Akihiro Obora, Yoshiki Murakami, Takao Kojima","doi":"10.1080/00365521.2024.2428280","DOIUrl":"10.1080/00365521.2024.2428280","url":null,"abstract":"<p><strong>Introduction: </strong>Vonoprazan has been known to have a high <i>Helicobacter pylori</i> (<i>H. pylori</i>) eradication rate since its launch in 2015. Yet, the risk factors for eradication failure and development of post-eradication gastric cancer (GC) using VPZ regimen remain unclear.</p><p><strong>Methods: </strong>This single-center cohort study included 934 consecutive patients who underwent <i>H. pylori</i> eradication using VPZ between February 2015 and June 2017 and were followed up for five years by the end of 2022. We examined several indicators of systemic immune, inflammatory, and nutritional status at the time of eradication to identify those indicators could predict eradication success, risk of post-eradication GC development, and long-term prognosis.</p><p><strong>Results: </strong>The successful eradication rates were 92.6% (intention-to-treat) and 98.7% (per-protocol). Multivariate analysis showed that only a high peripheral blood neutrophil-to-lymphocyte ratio (NLR) was significantly associated with eradication failure. The 5-year GC incidence rate was 1.67%, and all GCs were stage IA. The mean (standard deviation [SD]) time from eradication to diagnosis was 40.5 (6.1) months. Multivariate analysis showed that high NLR and history of GC and hypertension were significantly associated with GC development. Patients with elevated NLR post-eradication had a higher risk of newly developed GC. Twelve patients died during the study period, and a high NLR was associated with a significantly higher mortality rate.</p><p><strong>Conclusions: </strong>NLR has the potential to be a biomarker that predicts the failure of eradication and development of post-eradication GC. High NLR was also associated with poor long-term prognosis after <i>H. pylori</i> eradication.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1277-1288"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of functional defecation disorder in patients with constipation based on colonic transit test: a retrospective study.","authors":"Xiaoyang Ren, Xiaoni Yan, Jiao Zhu, Shuixiang He, Yan Yin","doi":"10.1080/00365521.2024.2434637","DOIUrl":"https://doi.org/10.1080/00365521.2024.2434637","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate the diagnostic efficacy of colonic transit test (CTT) in cases of constipation associated with functional defecation disorders (FDD) within the Chinese population.</p><p><strong>Methods: </strong>A retrospective analysis was conducted involving 202 patients diagnosed with functional constipation, who underwent CTT, high-resolution anorectal manometry, and balloon expulsion test. Participants were categorized based on the Rome IV criteria, comprising 103 patients with FDD and 99 without. The study examined the symptomatic characteristics of both groups and assessed the diagnostic utility of CTT in identifying constipation with FDD.</p><p><strong>Results: </strong>The predominant symptom reported among individuals with chronic functional constipation was excessive straining, observed in 69.3% of cases. The incidence of hard stool passage and feelings of incomplete evacuation were significantly greater in the FDD group compared to the non-FDD group (47.6% vs. 31.3%, <i>p</i> = 0.018 and 50.5% vs. 25.3%, <i>p</i> = 0.001, respectively). The presence of three or more rectosigmoid (RS) residual markers and a transit index of 40% or greater demonstrated moderate diagnostic value for FDD, characterized by low sensitivity(44.7% and 47.6%) but high specificity(76.8% and 75.8%). The RS residual markers were effective in differentiating between FDD and normal transit constipation, but not effectively distinguish between FDD and slow transit constipation.</p><p><strong>Conclusions: </strong>The presence of RS residue serves primarily as an exclusionary criterion for diagnosing FDD. In cases of slow transit constipation, but not normal transit constipation, it is imperative to conduct multiple kinetic assessments to accurately differentiate between FDD and other types of constipation.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-7"},"PeriodicalIF":1.6,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic indicators of insulin resistance: associations with erosive esophagitis and regular arrangement of collecting venules (RAC).","authors":"Hyun Tak Lee, Hyesun Hong, Ah Young Lee, Sang Jong Park, Jun-Young Seo","doi":"10.1080/00365521.2024.2431054","DOIUrl":"https://doi.org/10.1080/00365521.2024.2431054","url":null,"abstract":"<p><strong>Introduction: </strong>Insulin resistance is a key factor in metabolic syndrome. Identifying indicators of insulin resistance through endoscopic findings could be valuable in assessing a patient's systemic metabolic status. Thus, we conducted a retrospective study to investigate the association between endoscopic findings and insulin resistance.</p><p><strong>Methods: </strong>We reviewed 1,070 patients who underwent screening endoscopy with a rapid urease test at Bundang Jesaeng General Hospital from February 2023 to June 2023. Patients were classified based on insulin resistance using the Homeostatic Model Assessment for Insulin Resistance (HOMA_IR). Propensity score matching was performed to adjust for baseline characteristics.</p><p><strong>Results: </strong>After matching, 420 patients without insulin resistance and 210 with insulin resistance were selected. Endoscopic findings showed a significant association between insulin resistance and the presence of erosive esophagitis (<i>p</i> = 0.040). Furthermore, the severity of erosive esophagitis was positively correlated with the degree of insulin resistance, as indicated by an increased HOMA_IR. Multivariate analysis showed that erosive esophagitis significantly increased the risk of insulin resistance, while the presence of regular arrangement of collecting venules (RAC) was associated with a lower risk of insulin resistance.</p><p><strong>Conclusion: </strong>Insulin resistance is significantly associated with specific endoscopic findings, particularly erosive esophagitis and the absence of RAC, suggesting associations that may be useful in guiding further research into endoscopic indicators of metabolic complications. Moreover, we observed a proportional relationship between the severity of erosive esophagitis and the degree of insulin resistance. Further research is needed to explore these associations.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-8"},"PeriodicalIF":1.6,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Does this fecal microbiota transplant work?' Quality assurance of capsule based fecal microbiota transplant production.","authors":"Emil Ainsworth Jochumsen, Maja Skov Kragsnaes, Anna Christine Nilsson, Kristina Fruerlund Rasmussen, Torkell Ellingsen, Mie Agerbaek Juul, Jens Kjeldsen, Dorte Kinggaard Holm","doi":"10.1080/00365521.2024.2401460","DOIUrl":"10.1080/00365521.2024.2401460","url":null,"abstract":"<p><strong>Background: </strong>Fecal Microbiota Transplant (FMT) is an effective treatment for recurring Clostridioides Difficile Infections (rCDI). FMT administered <i>via</i> oral capsules (caFMT) offers several practical advantages to conventional liquid FMT. We began using caFMT in 2021 imported from an external institution. Based on similar production methods, we began our own caFMT production in 2022. We aimed to evaluate the quality of our caFMT.</p><p><strong>Study design and methods: </strong>We created a database of all FMT treatments (<i>n</i> = 180) provided by our institution. Quality of all FMT was evaluated by treatment success rates. We compared our caFMT to the imported caFMT.</p><p><strong>Results: </strong>Our caFMT yielded similar success rates compared to that of the imported caFMT, 65% (CI 95% 58-72%) and 72% (CI 95% 66-79%) respectively. FMT administered <i>via</i> colonoscopy had a significantly higher success rate, 79% (CI 95% 73-85%) than own our caFMT and other routes of administration. The combined success rate of treatments increased notably for all routes of administration when repeating FMT after prior failure.</p><p><strong>Discussion: </strong>The fact that our caFMT compared similarly to the imported caFMT was viewed as a success in terms of quality assurance. Our caFMT had a slightly lower success rates compared to data from other studies, but could be affected by several other factors than our FMT-production methods. A lower success rate of caFMT compared to FMT <i>via</i> colonoscopy is acceptable due to the practical advantages offed by caFMT. Our study serves as a practical example, proving that of the standardization of caFMT production is indeed viable.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1234-1239"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142353058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obstructive sleep apnoea is independently associated with non-alcoholic fatty pancreatic disease.","authors":"Jiaojiao Lin, Han Wang, Xiaoyang Chen, Lina Han, Zhibin Huang, Guorong Lyu, Shilin Li","doi":"10.1080/00365521.2024.2406559","DOIUrl":"10.1080/00365521.2024.2406559","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated the prevalence of non-alcoholic fatty pancreatic disease (NAFPD) in patients with obstructive sleep apnoea (OSA) and analysed the correlation between them.</p><p><strong>Materials and methods: </strong>Patients who underwent polysomnography and modified abdominal ultrasound examinations were continuously enrolled and divided into OSA and control groups. The OSA group was further divided into NAFPD and non-NAFPD groups. Differences in various indicators were compared. Binary logistic regression analyses were conducted to identify factors influencing NAFPD.</p><p><strong>Results: </strong>A total of 210 participants were included in the study, including 178 in the OSA group and 32 in the control group. The prevalence of NAFPD, weight, body mass index (BMI), and other indicators were significantly higher in the OSA group than that in the control group (<i>p</i> < 0.05). The above indices, prevalence of hypertension and metabolic associated steatotic liver disease (MASLD), and severity of sleep apnoea were higher in the NAFPD group than that in the non-NAFPD group (<i>p</i> < 0.05). Binary logistic regression analysis showed a 4.4% increased risk of NAFPD for each unit increase in apnea-hypopnea index (AHI) after adjusting for BMI and hypertension.</p><p><strong>Conclusion: </strong>The prevalence of NAFPD was higher in the OSA group than that in the control group, and chronic intermittent hypoxia was strongly associated with pancreatic fat infiltration; AHI, BMI, and hypertension were independent risk factors for NAFPD. The NAFPD group had a higher prevalence of obesity and some other diseases.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1252-1258"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142353059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The risk of cholangiocarcinoma in patients with MASLD is not increased compared to the general population.","authors":"Christina Villard, Linnea Widman, Ernesto Sparrelid, Annika Bergquist, Hannes Hagström","doi":"10.1080/00365521.2024.2412735","DOIUrl":"10.1080/00365521.2024.2412735","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasing in prevalence globally. MASLD is associated with an increased rate of comorbidities, including cardiovascular disease, liver cirrhosis, and hepatocellular carcinoma (HCC). While the link between MASLD and HCC is well known, the potential association with biliary tract cancer, including cholangiocarcinoma (CCA) and gallbladder cancer (GBC), is less certain. To evaluate whether individuals with MASLD are at increased risk of developing CCA compared to the general population, we performed a nationwide cohort study investigating the longitudinal association between MASLD and CCA.</p><p><strong>Methods: </strong>A retrospective cohort study was performed including all patients ≥18 years of age, diagnosed with MASLD, from 1^st of January 1987 to 31^st of December 2020, through the Swedish National Patient Register. For each patient with MASLD, ten individuals, matched to the MASLD patient on year of diagnosis, age, sex, and municipality were selected as reference individuals. The international Classification of Diseases (ICD) codes were used to define MASLD and incident CCA. Incidence rates were calculated, and regression analyses were performed.</p><p><strong>Results: </strong>Out of the 11,940 exposed patients with MASLD, 11 developed CCA (0.1%) out of whom three were diagnosed with iCCA (0.03%), during a median follow-up time of  five years. Out of 112,537 reference individuals, 62 were diagnosed with CCA (0.3%), out of whom 15 were diagnosed with iCCA (0.01%). The rate of GBC was not higher compared to the reference population.</p><p><strong>Conclusion: </strong>This large cohort study found a low incidence of CCA in patients with MASLD, comparable to the general population which can reassure clinicians and patients that no specific vigilance for CCA should be considered in MASLD patients at present.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1249-1251"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eradication rate and safety of vonoprazan-amoxicillin dual therapy for helicobacter pylori eradication: a randomized controlled trial.","authors":"Guoping Jiang, Mengzhao Luo, Peifen Zheng, Yanqun Cong, Yuliang Feng, Feng Zhou","doi":"10.1080/00365521.2024.2407898","DOIUrl":"10.1080/00365521.2024.2407898","url":null,"abstract":"<p><strong>Background: </strong>Helicobacter pylori (<i>H. pylori</i>), prevalent in developing regions, is a key factor in gastrointestinal diseases. Despite the common use of bismuth-based quadruple therapy, its drawbacks have prompted the search for alternatives. Recently, vonoprazan, a novel acid suppressant, has shown promise in combination with antibiotics as a dual therapy for <i>H. pylori</i> eradication. This study aimed to assess the therapeutic outcomes and adverse events of vonoprazan-amoxicillin dual therapy compared to quadruple therapy.</p><p><strong>Methods: </strong>A randomized controlled trial (RCT) enrolled <i>H. pylori</i>-infected patients at Zhejiang Hospital. Participants were randomly assigned to dual and quadruple therapy groups. The primary endpoints were <i>H. pylori</i> eradication and adverse events.</p><p><strong>Results: </strong>Of the 400 patients studied from April 2022 to June 2023, In the intention-to-treat (ITT) analysis, the eradication rates of H. pylori in vonoprazan-amoxicillin dual therapy group and quadruple therapy group were 94.0% and 87.0%, respectively, <i>p</i> = 0.017. In the per-protocol (PP) analysis were 97.9% and 93.0%, <i>p</i> = 0.022. Additionally, the dual therapy group had a significantly lower incidence of adverse events (19%) compared to the quadruple therapy group (53%) (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Vonoprazan-amoxicillin dual therapy demonstrates superior eradication efficacy and reduced adverse events compared to quadruple therapy in <i>H. pylori</i>-infected patients, suggesting its potential for clinical application and promotion.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1229-1233"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}