Vonoprazan on par with PPIs in BCQ therapy for H. pylori eradication

Vonoprazan-based bismuth-containing quadruple therapy (VBCQ) does better at eradicating Helicobacter pylori (H. pylori) than proton pump inhibitor (PPI)-based BCQ therapy (PBCQ), with similar adverse reactions and compliance, a study has shown.

“However, we conservatively believe that in H. pylori eradication, the VBCQ is not inferior to PBCQ because of the small absolute difference,” the authors said.

Relevant studies comparing VBCQ with PBCQ were searched in the databases of PubMed, Embase, Cochrane Library, CNKI, and Wanfang. The authors then performed combined analysis with risk ratio (RR) and 95 percent confidence intervals (CI) as effect values.

Ten studies met the eligibility criteria, of which seven were randomized controlled trials and three were cohort studies.

Intention-to-treat analysis revealed a significantly higher eradication rate with VBCQ than PBCQ (89.24 percent vs 84.03 percent; RR, 1.06, 95 percent CI, 1.03–1.10). In per-protocol analysis, VBCQ also showed a higher eradication rate than PBCQ (92.94 percent vs 87.82 percent), achieving a significant difference (RR, 1.06, 95 percent CI, 1.03–1.09). Similar results were seen in subgroup analysis.

In terms of safety, VBCQ and PBCQ showed similar incidence of adverse reactions (37.30 percent vs 34.94 percent). No significant between-group differences were observed (RR, 1.07, 95 percent CI, 0.96–1.19), neither in subgroup analysis.

Additionally, both treatment groups also had good compliance rates (94.32 percent vs 95.13 percent), with no significant difference (RR, 0.99, 95 percent CI, 0.95–1.04).