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

Zinan Zhang; Fen Liu; Feiyan Ai; Xiong Chen; Rui Liu; Chao Zhang; Ning Fang; Tian Fu; Xiaoyan Wang; Anliu Tang

doi:10.3389/fphar.2023.1143969

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

Front Pharmacol. 2023 May 5:14:1143969. doi: 10.3389/fphar.2023.1143969. eCollection 2023.

Authors

Zinan Zhang^{1

2}, Fen Liu^{1

3}, Feiyan Ai^{1

3}, Xiong Chen¹, Rui Liu¹, Chao Zhang¹, Ning Fang¹, Tian Fu¹, Xiaoyan Wang^{1

3}, Anliu Tang^{1

3}

Affiliations

¹ Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China.
² Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
³ Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Central South University, Changsha, Hunan, China.

Abstract

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.

Keywords: Helicobacter pylori; efficiency; eradication; safety; triple therapy; vonoprazan.

Associated data

ClinicalTrials.gov/NCT05097846