The Efficacy and Tolerability of a Triple Therapy Containing a Potassium-Competitive Acid Blocker Compared With a 7-Day PPI-Based Low-Dose Clarithromycin Triple Therapy


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Abstract

OBJECTIVES:This study evaluated the efficacy and tolerability of potassium-competitive acid blocker (P-CAB), a new class of gastric acid inhibitory agents, as first-lineH. pylorieradication treatment compared with 7-day proton pump inhibitor (PPI)-based triple therapy.METHODS:We retrospectively reviewed the medical records of 661 consecutive patients who received first-lineH. pylorieradication treatment between January 2013 and October 2015. Patients who received 7-day P-CAB therapy (vonoprazan 20 mg+amoxicillin 750 mg+clarithromycin 200 mg twice/day;n=181) were compared with those who received 7-day PPI therapy (lansoprazole 30 mg/rabeprazole 20 mg+amoxicillin 750 mg+clarithromycin 200 mg twice/day;n=480) using propensity score matching analysis. The successful eradication and adverse event rates were compared between the two groups.RESULTS:The propensity score matching analysis yielded 175 matched pairs. Adjusted comparisons between the two groups showed a significantly higher eradication rate for the P-CAB than the PPI group in both intention-to-treat (89.1 vs. 70.9%;P<0.001) and per-protocol analyses (91.2 vs. 71.7%;P<0.001). There was no significant difference in the incidence of adverse events between the two therapies except skin rash. No patients discontinuedH. pylorieradication treatment because of adverse events.CONCLUSIONS:Seven-day P-CAB-based triple therapy was more effective than 7-day PPI-based triple therapy as a first-lineH. pylorieradication treatment. Seven-day P-CAB-based triple therapy was generally well-tolerated.

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