医学
养生
兰索拉唑
阿莫西林
幽门螺杆菌
克拉霉素
内科学
胃肠病学
随机对照试验
雷贝拉唑
不利影响
意向治疗分析
置信区间
抗生素
生物
微生物学
作者
Masafumi Maruyama,Naoki Tanaka,Daisuke Kubota,Masayuki Miyajima,Takefumi Kimura,Koujiro Tokutake,Ryujiro Imai,Toru Fujisawa,Hiromitsu Mori,Yoshiaki Matsuda,Shinpei Wada,Akira Horiuchi,Kendo Kiyosawa
摘要
Background. A new agent, potassium-competitive acid blocker vonoprazan (VPZ) has potent acid-inhibitory effects and may offer advantages over conventional H. pylori eradication therapies. We aimed to compare the eradication rate between VPZ-based treatment and PPI-based one. Methods. This randomized controlled trial was designed to assign 141 patients with H. pylori-positive gastritis to VPZ group (VPZ 20 mg, amoxicillin 750 mg, and clarithromycin 200 or 400 mg twice daily for 7 days) or PPI group (rabeprazole 20 mg or lansoprazole 30 mg, amoxicillin 750 mg, and clarithromycin 200 or 400 mg twice daily for 7 days). Primary endpoints were eradication rates and adverse events. Results. Seventy of 72 patients in VPZ group and 63 of 69 patients in PPI group completed the treatment after 7 days. The eradication rate was significantly higher in VPZ group than PPI group by intention-to-treat analysis (95.8% versus 69.6%, P = 0.00003, 95% confidence interval [CI] 88.3-99.1% versus 57.3-80.1%) and per-protocol analysis (95.7% versus 71.4%, P = 0.0002, 95% CI 88.0-99.1% versus 58.7-82.1%). The incidence of adverse events was not different between the groups (26.3% in VPZ group versus 37.7% in PPI group, P = 0.15). Conclusion. VPZ-based regimen is more useful than that PPI-based regimen as a first-line H. pylori eradication therapy.
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