+40 264 433427

Article 6, 3/2016

ORIGINAL PAPER

A Novel Potassium-Competitive Acid Blocker Improves the Efficacy of Clarithromycin-containing 7-day Triple Therapy against Helicobacter pylori

download Full Article (PDF file)

Hisatsugu Noda, Seiji Noguchi, Takashi Yoshimine, Shigeki Goji, Kazunori Adachi, Yasuhiro Tamura, Shinya Izawa, Masahide Ebi, Sayuri Yamamoto, Naotaka Ogasawara, Yasushi Funaki, Makoto Sasaki, Kunio Kasugai

Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, Japan

DOI: http://dx.doi.org/10.15403/jgld.2014.1121.253.7hp

ABSTRACT
Background & Aims: In Japan, 7-day triple therapy for Helicobacter pylori including clarithromycin (CAM) was approved in 2000. However, antibiotic resistance subsequently reduced this rate to an unacceptable level (70%). Vonoprazan, an orally bioavailable potassium-competitive acid blocker (P-CAB), was approved in Japan in 2014. This could improve eradication rates by increasing the intragastric pH, thus increasing bacterial antibiotic susceptibility. This study compared the efficacy of 7-day triple therapies that included CAM and vonoprazan or proton pump inhibitor (PPI).

Methods: We prospectively analyzed H. pylori eradication rates in 146 patients receiving 7-day triple therapy containing P-CAB (April 2015 to September 2015), and in a retrospective cohort of 1,305 patients who received 7-day triple therapy containing a PPI (April 2011 to September 2015).

Results: H. pylori was eradicated in a significantly higher number of P-CAB-treated patients (89.7% [131/146]) than PPI-treated patients (73.9% [965/1305]; p < 0.05). The eradication rates in P-CAB-treated CAM-sensitive and CAM-resistant bacteria were 100% (44/44) and 87.5% (28/32), respectively, which were significantly higher than the corresponding rates in PPI-treated patients (88.0% [22/25] and 53.8% [7/13], p < 0.05).
Conclusion: P-CAB improved the efficacy of CAM-containing 7-day triple therapy and would be a valuable first-line treatment for H. pylori infection.

Key words: Helicobacter pylori – triple therapy – potassium-competitive acid blocker – vonoprazan.

Abbreviations: CAM: clarithromycin; CAM-R: clarithromycin- resistant; CAM-S: clarithromycin-sensitive; OR: odds ratio; P-CAB: potassium-competitive acid blocker; PPI: proton pump inhibitor.