The efficacy and mechanism of vonoprazan-containing triple therapy in the eradication of Helicobacter pylori

Frontiers in Pharmacology

Pharmacology

Xiong Chen¹  Ning Fang¹  Rui Liu¹  Chao Zhang¹  Tian Fu¹  Zinan Zhang²  Fen Liu³  Anliu Tang³  Xiaoyan Wang³  Feiyan Ai³ 

[1] Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China;Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China;Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China;Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China;Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Central South University, Changsha, Hunan, China;

关键词: Helicobacter pylori;    eradication;    vonoprazan;    triple therapy;    efficiency;    safety;   

DOI  :  10.3389/fphar.2023.1143969

 received in 2023-01-13, accepted in 2023-04-07,  发布年份 2023

来源: Frontiers

【 摘 要 】

Purpose: Vonoprazan (VPZ) produces a strong acid-inhibitory effect, which can potentially eradicate Helicobacter Pylori (H. pylori). We aimed to assess whether a 14-day VPZ-containing triple therapy was safe and effective in the Chinese population and the potential mechanism.Methods: Enrolled patients confirmed to be infected with H. pylori were randomly divided into four groups: VPZ + doxycycline + furazolidone, VPZ + doxycycline + amoxicillin, esomeprazole (EPZ) + bismuth + doxycycline + furazolidone, and EPZ + colloidal bismuth + doxycycline + amoxicillin for 14 days. The eradication rate, medication adherence, and incidence of adverse events (AEs) were evaluated. Inhibition of H. pylori by VPZ and EPZ in vitro was assessed. H. pylori treated with appropriate concentrations of VPZ and EPZ were sequenced by transcriptome analysis to explore the antibacterial mechanism.Results: A higher eradication rate were observed in VPZ-containing triple therapy. No obvious differences were observed in medication adherence or the incidence of AEs. VPZ had no direct inhibitory effect on H. pylori, whereas EPZ directly inhibited H. pylori may through downregulated genes related to the ribosome.Conclusion: In the Chinese population, 14-day VPZ-containing triple therapy was safe and more effective and can be used clinically as first-line H. pylori treatment.Clinical Trial Registration: ClinicalTrials.gov, identifier NCT05097846

【 授权许可】

Unknown   
Copyright © 2023 Zhang, Liu, Ai, Chen, Liu, Zhang, Fang, Fu, Wang and Tang.