Helicobacter pylori Eradication with Proton Pump Inhibitors or Potassium-Competitive Acid Blockers: The Effect of Clarithromycin Resistance
Helicobacter pylori Eradication with Proton Pump Inhibitors or Potassium-Competitive Acid Blockers: The Effect of Clarithromycin Resistance
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DOI：
10.1007/s10620-016-4305-0
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发表时间：
2016-11-01
影响因子：
3.1
通讯作者：
Graham, David Y.
中科院分区：
文献类型：
--
作者：
Matsumoto, Hiroshi;Shiotani, Akiko;Graham, David Y.
沃诺拉赞是一种新型钾竞争性酸阻滞剂（P-CAB），最近在日本获批用于幽门螺杆菌根除治疗。比较含PPI和P-CAP的三联疗法与含沃诺拉赞的三联疗法。295例初始受试者接受含PPI的三联疗法;接下来的125例受试者接受含沃诺拉赞的三联疗法。两个连续组接受7天根除方案，包括阿莫西林750 mg、克拉霉素200 mg，每日两次，以及标准剂量PPI或沃诺拉赞（20 mg，每日两次）。H.通过13 C-UBT证实幽门螺杆菌根除。通过23 S rRNA PCR评价克拉霉素敏感性。PPI和沃诺拉赞治疗克拉霉素敏感菌株的群体治愈率分别为89.6%和100%。PPI治疗耐药菌株的治愈率为40.2%，沃诺拉赞三联治疗为76.1%。虽然7天P-CAB三联疗法上级于7天PPI三联疗法，但在克拉霉素耐药感染的情况下，两者均不具有高度有效性，也不值得推荐。
Vonoprazan is a novel potassium-competitive acid blocker (P-CAB) recently approved for Helicobacter pylori eradication therapy in Japan.To compare PPI- and P-CAP-containing triple therapy and vonoprazan-based triple therapy.Two hundred ninety-five initial subjects received a PPI-containing triple therapy; the next 125 subjects received vonoprazan-containing triple therapy. Two sequential groups received 7-day eradication regimens consisting of amoxicillin 750 mg, clarithromycin 200 mg both twice a day with standard dose PPI or vonoprazan (20 mg) each twice daily. H. pylori eradication was confirmed by a 13C-UBT. Clarithromycin susceptibility was evaluated by 23S rRNA PCR.Population cure rates with clarithromycin susceptible strains were 89.6 versus 100 % for PPI and vonoprazan therapies, respectively. Cure rates with resistant strains were 40.2 % with PPI therapy versus 76.1 % with vonoprazan triple therapy. There was no difference in side effects.Although 7-day P-CAB triple therapy was superior to 7-day PPI triple therapy, neither was highly effective, or can be recommended, in the presence of clarithromycin-resistant infections.