Real-world research of vonoprazan and amoxicillin dual therapy for <italic style="font-style: italic">Helicobacter pylori</italic> eradication

HUANG Yuanlong; ZUO Houdong; MAO Benhong; ZHAO Wei; ZHANG Ying; LI Yaxiong; YING Yin; GAN Lu

doi:10.6039/j.issn.1001-0408.2023.22.16

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Real-world research of vonoprazan and amoxicillin dual therapy for Helicobacter pylori eradication

更新时间：2023-11-25

- Real-world research of vonoprazan and amoxicillin dual therapy for Helicobacter pylori eradication
- ZHONGGUO YAOFANG Vol. 34, Issue 22, Pages: 2775-2779(2023)
- 作者机构：
  
  1.成都新华医院消化内科，成都　610067
  2.成都新华医院放射科，成都　610067
  3.川北医学院附属医院放射科/四川医学影像学重点实验室，四川南充　637000
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2023.22.16
  CLC： R714.255;R969.3
- Published：30 November 2023，
  
  Received：10 June 2023，
  
  Revised：12 September 2023，
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黄元龙,左后东,毛本红等.伏诺拉生与阿莫西林二联方案根除幽门螺杆菌的真实世界研究 ^Δ[J].中国药房,2023,34(22):2775-2779.

HUANG Yuanlong,ZUO Houdong,MAO Benhong,et al.Real-world research of vonoprazan and amoxicillin dual therapy for Helicobacter pylori eradication[J].ZHONGGUO YAOFANG,2023,34(22):2775-2779.
黄元龙,左后东,毛本红等.伏诺拉生与阿莫西林二联方案根除幽门螺杆菌的真实世界研究 ^Δ[J].中国药房,2023,34(22):2775-2779. DOI： 10.6039/j.issn.1001-0408.2023.22.16.

HUANG Yuanlong,ZUO Houdong,MAO Benhong,et al.Real-world research of vonoprazan and amoxicillin dual therapy for Helicobacter pylori eradication[J].ZHONGGUO YAOFANG,2023,34(22):2775-2779. DOI： 10.6039/j.issn.1001-0408.2023.22.16.

摘要

目的

探讨常规剂量伏诺拉生联合常规剂量阿莫西林二联方案用于幽门螺杆菌（HP）感染初次治疗患者的疗效、安全性及经济性。

方法

采用前瞻性队列研究方法，根据纳排标准纳入2021年7月至2022年7月在成都新华医院消化内科门诊诊断为HP感染且初次接受治疗的患者，根据患者用药意愿分别接受伏诺拉生+阿莫西林二联方案（即VA组，富马酸伏诺拉生片20 mg，每天1次+阿莫西林胶囊1.0 g，每天2次，疗程14 d）和经典的含铋剂四联方案（即LJAF组，雷贝拉唑肠溶片20 mg，每天2次+胶体果胶铋胶囊200 mg，每天2次+阿莫西林胶囊1.0 g，每天2次+呋喃唑酮片100 mg，每天2次，疗程14 d）。治疗结束4周后，采用意向治疗（ITT）、改良的意向治疗（MITT）、按方案治疗（PP）分析，比较两组患者的HP清除率；记录其不良反应发生情况，并进行经济性评价。

结果

VA组58例患者中，55例完成试验，2例失访，1例因皮疹退出；LJAF组62例患者中，57例完成试验，3例失访，2例因皮疹退出。ITT、MITT、PP分析结果显示，VA组患者的HP根除率分别为86.2%、89.3%、90.9%，LJAF组患者的HP根除率分别为87.1%、91.5%、94.7%，组间比较差异均无统计学意义（

＞0.05）。VA组、LJAF组患者的不良反应发生率分别为6.9%、14.5%，组间比较差异亦无统计学意义（

＞0.05）。最小成本分析结果显示，VA组患者的治疗总成本为340.9元，低于LJAF组的373.5元。

结论

常规剂量伏诺拉生联合常规剂量阿莫西林二联方案用于HP感染初次治疗患者的疗效和安全性与经典的含铋剂四联方案相当，且总成本更低。

Abstract

OBJECTIVE

To explore the efficacy， safety and economics of a dual therapy consisting of conventional dose of vonoprazan combined with conventional dose of amoxicillin in patients with primary treatment of

Helicobacter pylori

（HP） infection.

METHODS

Using a prospective cohort study， the patients diagnosed with HP infection and receiving initial treatment in Chengdu Xinhua Hospital from July 2021 to July 2022 were collected according to inclusion and exclusion criteria. The patients were given vonoprazan/amoxicillin dual therapy （i.e. VA group， Vonoprazan fumarate tablets 20 mg， once a day+Amoxicillin capsules 1.0 g， twice a day， 14 days） and bismuth-containing quadruple therapy （i.e. LJAF group， Rabeprazole sodium enteric-coated tablets 20 mg， twice a day+Colloidal bismuth pectin capsules 200 mg， twice a day+Amoxicillin capsules 1.0 g， twice a day+Furazolidone tablets 100 mg， twice a day， for 14 days） according to the patient’s medication willingness. Four weeks after the end of the treatment， HP eradication rates of the two groups were compared by using intention-to-treat （ITT）， modified intention-to-treat （MITT） and per-protocol （PP） analysis. The occurrence of adverse drug reactions （ADR） was recorded， and an economic evaluation was performed for them.

RESULTS

Among the 58 patients in VA group， 55 completed the trial， 2 were lost to follow-up and one withdrew due to rash； among the 62 patients in LJAF group， 57 completed the trial， 3 were lost to follow-up and 2 withdrew due to rash. Results of ITT， MITT and PP analysis showed that HP eradication rates of VA group were 86.2%， 89.3% and 90.9%， and those of LJAF group were 87.1%， 91.5% and 94.7%， respectively； there was no statistical significance among different groups （

＞0.05）. The incidences of ADR in VA group and LJAF group were 6.9% and 14.5%， which were not significantly different （

＞0.05）. The result of cost minimization analysis showed that the treatment cost of VA group was 340.9 yuan， which was lower than 373.5 yuan of LJAF group.

CONCLUSIONS

In patients with primary treatment of

infection， the efficacy and safety of dual therapy of conventional dose of vonoprazan combined with conventional dose of amoxicillin is equivalent to the bismuth-containing quadruplex therapy with low cost.

关键词

伏诺拉生阿莫西林幽门螺杆菌含铋剂四联方案疗效安全性最小成本分析

Keywords

amoxicillinHelicobacter pyloribismuth-containing quadruple therapyefficacysafetycost minimization analysis

references

LEJA M，AXON A，BRENNER H. Epidemiology of Helicobacter pylori infection[J]. Helicobacter，2016，21（S1）：3-7.

SUGANO K，TACK J，KUIPERS E J，et al. Kyoto global consensus report on Helicobacter pylori gastritis[J]. Gut，2015，64（9）：1353-1367.

MALFERTHEINER P，MEGRAUD F，ROKKAS T，et al. Management of Helicobacter pylori infection：the Maastricht Ⅵ/florence consensus report[J]. Gut，2022，71（9）：1724-1762.

中华医学会消化病学分会幽门螺杆菌学组. 第六次全国幽门螺杆菌感染处理共识报告：非根除治疗部分[J]. 中华消化杂志，2022，42（5）：289-303.

Helicobacter pylori Study Group of Chinese Society of Gastroenterology. Sixth Chinese national consensus report on the management of Helicobacter pylori infection：treatment excluded[J]. Chin J Dig，2022，42（5）：289-303.

YANG J，ZHANG Y，FAN L，et al. Eradication efficacy of modified dual therapy compared with bismuth-containing quadruple therapy as a first-line treatment of Helicobacter pylori[J]. Am J Gastroenterol，2019，114（3）：437-445.

ÖZTÜRK K，KURT Ö，ÇELEBI G，et al. High-dose dual therapy is effective as first-line treatment for Helicobacter pylori infection[J]. Turk J Gastroenterol，2020，31（3）：234-238.

SCARPIGNATO C，HUNT R H. Editorial：towards extended acid suppression：the search continues[J]. Aliment Pharmacol Ther，2015，42（8）：1027-1029.

YANG X X，LI Y Y，SUN Y Y，et al. Vonoprazan：a novel and potent alternative in the treatment of acid-related di-seases[J]. Dig Dis Sci，2018，63（2）：302-311.

FURUTA T，YAMADE M，KAGAMI T，et al. Dual therapy with vonoprazan and amoxicillin is as effective as triple therapy with vonoprazan，amoxicillin and clarithromycin for eradication of Helicobacter pylori[J]. Digestion，2020，101（6）：743-751.

ATKINSON N S S，BRADEN B. Helicobacter pylori infection：diagnostic strategies in primary diagnosis and after therapy[J]. Dig Dis Sci，2016，61（1）：19-24.

刘成裕，刘广宣. 药物经济学：评价与应用[J]. 中国药物经济学，2019，14（2）：122-128.

LIU C Y，LIU G X. Pharmacoeconomics：evaluation and application[J]. China J Pharm Econ，2019，14（2）：122-128.

刘国恩. 中国药物经济学评价指南2020[M]. 北京：中国市场出版社，2020：87-96.

LIU G E. China guidelines for pharmacoeconomic evalu-ations 2020[M]. Beijing：China Market Publishing Associ-ation，2020：87-96.

窦冠珅，卢建龙，祁方家，等. 药物经济学评价中的不确定性分析[J]. 上海医药，2015，36（1）：10-13.

DOU G S，LU J L，QI F J，et al. The analysis of uncertainty in pharmacoeconomic evaluations[J]. Shanghai Med Pharm J，2015，36（1）：10-13.

GRAHAM D Y，DORE M P. Helicobacter pylori therapy：a paradigm shift[J]. Expert Rev Anti Infect Ther，2016，14（6）：577-585.

MURAKAMI K，SAKURAI Y，SHIINO M，et al. Vonoprazan，a novel potassium-competitive acid blocker，as a component of first-line and second-line triple therapy for Helicobacter pylori eradication：a phase Ⅲ，randomised，double-blind study[J]. Gut，2016，65（9）：1439-1446.

GAO W，TENG G G，WANG C，et al. Eradication rate and safety of a simplified rescue therapy：14-day vonoprazan and amoxicillin dual regimen as rescue therapy on treatment of Helicobacter pylori infection previously failed in eradication：a real-world，retrospective clinical study in China[J]. Helicobacter，2022，27（5）：e12918.

MARTINUCCI I，BLANDIZZI C，BODINI G，et al. Vonoprazan fumarate for the management of acid-related di-seases[J]. Expert Opin Pharmacother，2017，18（11）：1145-1152.

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Real-world research of vonoprazan and amoxicillin dual therapy for Helicobacter pylori eradication

DOI：10.6039/j.issn.1001-0408.2023.22.16

摘要

Abstract

关键词

Keywords

references