Comparison of vonoprazan with different frequency Amoxicillin regimens in the treatment of Helicobacter pylori infections: A retrospective study

This study aims to evaluate the efficacy of vonoprazan combined with amoxicillin (vonoprazan-amoxicillin [VA]) at the same dose but different administration frequencies in treating Helicobacter pylori (Helicobacter pylori [Hp]) infection. This retrospective study analyzed 236 Hp-positive patients. Patients were treated with the VA regimen for 14 days and divided based on amoxicillin administration frequency: L-VA: vonoprazan 20 mg bid + amoxicillin 1 g tid; H-VA: vonoprazan 20 mg bid + amoxicillin 0.75 g qid. A 13C or 14C-urea breath test was performed at least 4 weeks posttreatment to assess eradication rates and adverse events in both groups. The eradication rates of L-VA and H-VA were 85.5% and 93.8%, respectively. The eradication rate of H-VA group was higher than L-VA group, the difference between 2 groups was statistically significant (P = .039). The incidence of adverse events was 8.1% in the L-VA group and 7.1% in the H-VA group, but there was no significant difference in the incidence of adverse events between the groups (P = .258). BMI and the overall eradication rates in 2 groups showed no significant difference (P = .102). However, Among patients with BMI ≥ 24%, the eradication rate of H-VA group reached 100%, which significantly differed from the L-VA group (P = .039). Amoxicillin administered 4 times daily is more effective than 3 times daily in eradicating Hp, with an eradication rate > 90% and lower adverse events incidence, improving related discomfort symptoms. This regimen is recommended as the first-line treatment for Hp.