Vonoprazan-Based versus Esomeprazole-Based Triple Therapy for
Helicobacter Pylori, a Randomized Trial
Background: Vonoprazan-based regimens are anticipated to have higher
Helicobacter pylori eradication rates than PPIs. Aim and objective: to
compare between the effectiveness of two 14-day regimens; one based on
vonoprazan and the other on esomeprazole, to eradicate H. pylori.
Patients and methods: Participants were determined to have active H.
pylori infection and were either untreated or had previously received
therapy were randomly assigned to either the VAL group (vonoprazan 20 mg
bid, amoxicillin 1000 mg bid, plus levofloxacin 500 mg once day) or the
EAL group (Esomeprazole 20 mg bid., amoxicillin 1000 mg bid., and
levofloxacin 500 mg once daily). After 4-6 weeks following the end of
the therapy, an H. pylori antigen test was used to determine the degree
of eradication. Results: A number of 122 individuals were randomly
assigned to either the VAL (n = 61) or EAL (n = 61) groups, and 118
patients were successful in completing the study. The eradication rates
of H. pylori were found to be 97.7 percent for the VAL group and 68.5
percent for the EAL group, respectively (P = 0.031). All adverse
treatment-related occurrences were minor and did not differ
substantially between the two groups, such as nausea and vertigo.
Conclusions: The VAL regimen was well tolerated and led to increased
eradication rates; as a result, VAL may be thought of as a powerful
regimen for treating H. pylori, particularly in nations with high levels
of antibiotic resistance.