Efficacy and safety of vonoprazan and high-dose amoxicillin dual therapy in eradicating Helicobacter pylori: A systematic review and meta-analysis

• Published in: International journal of antimicrobial agents 2024-11, Vol.64 (5), p.107331, Article 107331
• Main Authors: Zhang, Ju, Zhang, Huan, Zhu, Xiao-Jing, Yao, Nuo, Yin, Ju-Mei, Liu, Jian, Dan, Han-Jun, Pang, Qi-Meng, Liu, Zhi-Hua, Shi, Yong-Quan
• Format: Article
• Language: English
• Subjects: Amoxicillin; Amoxicillin - administration & dosage; Amoxicillin - therapeutic use; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - adverse effects; Anti-Bacterial Agents - therapeutic use; bismuth; compliance; confidence interval; Drug Therapy, Combination; Dual therapy; guidelines; Helicobacter Infections - drug therapy; Helicobacter pylori; Helicobacter pylori - drug effects; Humans; Meta-analysis; odds ratio; proton pump; Proton Pump Inhibitors - administration & dosage; Proton Pump Inhibitors - adverse effects; Proton Pump Inhibitors - therapeutic use; Pyrroles - administration & dosage; Pyrroles - adverse effects; Pyrroles - therapeutic use; Randomized Controlled Trials as Topic; Sulfonamides - administration & dosage; Sulfonamides - adverse effects; Sulfonamides - therapeutic use; systematic review; therapeutics; Treatment Outcome; Vonoprazan
• ISSN: 0924-8579; 1872-7913; 1872-7913
• DOI: 10.1016/j.ijantimicag.2024.107331

•Efficacy and safety of vonoprazan and high-dose amoxicillin (VHA) dual therapy in eradicating Helicobacter pylori was evaluated.•VHA dual therapy is significantly more effective than bismuth quadruple therapy based on proton pump inhibitors (P-BQT).•H. pylori eradication rates of over 90% were seen with 10-day VHA and 14-day VHA.•VHA dual therapy had fewer adverse events and similar compliance compared with that of the control. Vonoprazan is a new acid-suppressing drug that provides an additional choice for eradicating Helicobacter pylori. The effectiveness and safety of vonoprazan and high-dose amoxicillin (VHA) dual therapy requires study in a systematic analysis. A comprehensive search of the literature from the PubMed, Embase, Cochrane Library, and Web of Science databases was conducted up to 16 May 2024. Trials comparing H. pylori eradication rates, adverse events, and compliance of VHA dual therapy with that of other therapies were included. RevMan 5.4 was used for statistical analysis. Eleven randomised controlled trials (RCTs) and two retrospective clinical studies with 4570 samples were included. VHA dual therapy had superior H. pylori eradication rates (intention-to-treat [ITT]: 86.0% vs. 80.7%; odds ratio [OR]=1.36; 95% confidence interval [CI] 1.07–1.73; P=0.01; per-protocol [PP]: 90.6% vs. 85.7%; OR=1.42; 95% CI 1.07–1.88; P=0.02), fewer adverse events (15.4% vs. 27.7%; OR=0.49; 95% CI 0.35–0.68, P