Vonoprazan-amoxicillin dual therapy for Helicobacter pylori eradication: Clinical, pharmacogenetic, and microbiome perspectives

doi:10.3748/wjg.116530

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Opinion Review

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Jul 14, 2026; 32(26): 116530
Published online Jul 14, 2026. doi: 10.3748/wjg.116530

Vonoprazan-amoxicillin dual therapy for Helicobacter pylori eradication: Clinical, pharmacogenetic, and microbiome perspectives

Hou-Shu Tu, Meng-Lin Chen, Jing Hong, Ling He

Hou-Shu Tu, Meng-Lin Chen, Ling He, Department of Clinical Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang 330004, Jiangxi Province, China

Jing Hong, Department of Otorhinolaryngology, Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang 330006, Jiangxi Province, China

Ling He, Department of Gastroenterology, Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang 330006, Jiangxi Province, China

Author contributions: Tu HS and He L conceived and designed the opinion review; Tu HS drafted the manuscript; Chen ML and Hong J participated in the revision of the manuscript. All authors have read and approved the final manuscript.

AI contribution statement: ChatGPT and language-editing tools were used during manuscript preparation for English language polishing, wording refinement, and improvement of readability. Some schematic figures/graphical elements were generated with the assistance of AI-based image-generation tools based on the concepts, structure, and scientific content specified by the authors. These figures are illustrative only and do not represent original experimental data, clinical images, pathological images, or independently generated scientific conclusions. The authors reviewed, revised where necessary, and approved all AI-assisted graphical outputs. The authors confirm that all scientific content, arguments, interpretations, conclusions, and final manuscript decisions were made by the authors. The authors take full responsibility for the accuracy, integrity, originality, and final content of the manuscript.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Corresponding author: Ling He, PhD, Chief Physician, Professor, Department of Gastroenterology, Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, No. 445 Bayi Avenue, Nanchang 330006, Jiangxi Province, China. heling118@126.com

Received: November 14, 2025
Revised: January 7, 2026
Accepted: January 26, 2026
Published online: July 14, 2026
Processing time: 225 Days and 15.3 Hours

Core Tip

Core Tip: Vonoprazan-amoxicillin dual therapy is a potent, well-tolerated first-line regimen for Helicobacter pylori eradication, even in regions where clarithromycin resistance is prevalent. This opinion review integrates multicenter evidence, pharmacogenetics, and microbiome considerations, highlights unresolved controversies, and proposes a sequential roadmap for safe, globally applicable implementation to reduce the global burden of associated gastrointestinal diseases.