Ten-day tegoprazan-based concomitant therapy as a first-line treatment for Helicobacter pylori eradication

Korean J Intern Med. 2023 Jul;38(4):493-503. doi: 10.3904/kjim.2022.345. Epub 2023 Jun 28.

Abstract

Background/aims: Tegoprazan, a novel potassium-competitive acid blocker, has shown rapid action and gastric acid inhibition. In this study, we evaluated the efficacy of a tegoprazan-based, nonbismuth-containing quadruple (concomitant) therapy for the primary eradication of Helicobacter pylori.

Methods: We conducted a prospective, single-arm, single-center, primitive study to verify the efficacy of a 10-day tegoprazan- based (50-mg dose) concomitant therapy, including amoxicillin (1,000-mg dose), clarithromycin (CLA; 500-mg dose), and metronidazole (MET; 500-mg dose) twice daily as a first-line treatment for H. pylori eradication.

Results: We tested consecutive cultures for antibiotic susceptibility and minimum inhibitory concentrations. We enrolled 84 participants; 79 (94.0%) completed first-line therapy. The overall intention-to-treat and per-protocol eradication rates were 90.5% (95% confidence interval [CI], 82.1-95.8) and 96.2% (95% CI, 83.4-97.6), respectively. Of the 73 participants evaluated for antibiotic resistance, 19 (26.0%), 32 (42.5%), and 8 (11.0%) exhibited CLA, MET, and CLA and MET dual resistance, respectively. Of these, 39 participants (66.1%) exhibited successful eradication after the therapeutic regimen despite antibiotic resistance.

Conclusion: The 10-day tegoprazan-based concomitant therapy may be an effective first-line treatment for eradicating H. pylori.

Keywords: Antibiotic resistance; Clarithromycin; Helicobacter pylori; Metronidazole; Tegoprazan.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amoxicillin / adverse effects
  • Anti-Bacterial Agents / adverse effects
  • Clarithromycin / adverse effects
  • Drug Resistance, Bacterial
  • Drug Therapy, Combination
  • Helicobacter Infections* / diagnosis
  • Helicobacter Infections* / drug therapy
  • Helicobacter pylori*
  • Humans
  • Metronidazole / adverse effects
  • Prospective Studies
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • tegoprazan
  • Amoxicillin
  • Metronidazole
  • Clarithromycin

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