Comparative study: Vonoprazan and proton pump inhibitors in Helicobacter pylori eradication therapy

Table 1 Baseline and demographic characteristics of patients in this study

	First-line eradication therapy					Second-line eradication therapy
	VPZ group	PPI group	EPZ group	RPZ group	LPZ group	VPZ group	PPI group	EPZ group	RPZ group	LPZ group
	n = 546	n = 807	n = 507	n = 89	n = 211	n = 76	n = 185	n = 104	n = 24	n = 57
Age, mean ± SD, yr	57.4 ± 11.8	56.7 ± 12.8	56.9 ± 11.6	60.7 ± 11.2	56.1 ± 12.1	56.9 ± 12.8	56.0 ± 12.6	57.5 ± 12.5	58.2 ± 12.2	58.1 ± 12.3
Sex, n (%)
Male	225 (41.2)	318 (39.4)	193 (38.1)	35 (39.3)	90 (42.7)	30 (39.5)	71 (38.4)	39 (37.5)	9 (39.3)	23 (40.4)
Female	321 (58.8)	489 (60.6)	314 (61.9)	54 (60.7)	121 (57.3)	46 (60.5)	114 (61.6)	65 (62.5)	15 (60.7)	34 (59.6)
Indication
GU(s)	32	33	18	4	11	3	7	6	0	1
DU(s)	37	68	36	8	24	5	13	5	2	6
GDU(s)	4	4	2	1	1	1	0	0	0	0
MALT lymphoma	0	2	0	0	2	0	1	0	0	1
Post ESD	1	3	2	0	1	1	0	0	0	0
Atrophic gastritis	472	697	449	76	172	66	164	93	22	49

GU/GUs: Gastric ulcer and/or ulcer scar; DU/DUs: Duodenal ulcer and/or ulcer scar; GDU/GDUs: Gastroduodenal ulcer and/or ulcer scar; MALT: Mucosa-associated lymphoid tissue; ESD: Endoscopic submucosal dissection; VPZ: Vonoprazan; PPI: Proton pump inhibitor; EPZ: Esomeprazole; RPZ: Rabeprazole; LPZ: Lansoprazole.

Table 2 Univariate analysis of predictors for successful Helicobacter pylori first-line eradication

	VPZ group				PPI group
	Eradication rate	OR	95%CI	P value	Eradication rate	OR	95%CI	P value
Sex
Male	90.2%	1			67.0%	1
Female	86.3%	0.682	0.396-1.174	0.17	66.9%	0.995	0.737-1.343	0.97
Age (yr)
< 60	86.6%	1			74.1%	1
≥ 60	87.9%	1	0.598-1.673	1	76.7%	1.155	0.860-1.551	0.34
BMI (kg/m2)
< 25	88.4%	1			69.1%	1
≥ 25	86.5%	0.843	0.464-1.530	0.57	68.8%	0.987	0.683-1.435	0.94
Smoking
No	87.3%	1			68.1%	1
Yes	91.3%	1.412	0.583-3.420	0.44	56.6%	0.611	0.412-0.906	0.01
Alcohol
Non-drinker	88.1%	1			67.7%	1
Drinker	87.4%	0.937	0.555-1.580	0.81	67.3%	0.984	0.716-1.352	0.92
Atrophy
Closed type	87.9%	1			65.6%	1
Open type	89.1%	1.130	0.619-2.069	0.69	65.6%	0.998	0.708-1.408	0.99

VPZ: Vonoprazan; PPI: Proton pump inhibitor.

Table 3 Adverse events in first- and second-line eradication therapies n (%)

	First-line eradication therapy				Second-line eradication therapy
	VPZ	EPZ	RPZ	LPZ	VPZ	EPZ	RPZ	LPZ
Adverse events	61 (11.2)	39 (7.7)	9 (10.1)	12 (5.7)	6 (7.9)	14 (13.5)	3 (12.5)	7 (12.3)
Diarrhoea/soft stool	29 (47.5)	25 (64.1)	5 (55.6)	8 (66.7)	4 (66.7)	6 (43.0)	3 (100)	5 (71.4)
Eruption	7 (11.5)	3 (7.7)	2 (22.2)	2 (16.7)	0	3 (21.4)	0	0
Constipation	6 (10.0)	3 (7.7)	0	0
Dysgeusia	3 (5.0)	3 (7.7)	1 (11.1)	0	0	1 (7.1)	0	1 (14.3)
Nausea and vomiting	2 (3.3)	2 (5.1)	0	1 (8.3)	0	1 (7.1)	0	0
Abdominal pain	5 (8.2)	2 (5.1)	0	0	1 (16.7)	2 (14.3)	0	0
Appetite loss	3 (5.0)	0	0	0
General fatigue	2 (3.3)	1 (2.6)	0	0	1 (16.7)	0	0	0
Heartburn	1 (1.6)	0	0	1 (8.3)
Headache	1 (1.6)	0	0	0	0	0	0	1 (14.3)
Fever	1 (1.6)	0	0	0
Flatulence	0	0	1 (11.1)	0
Haematuria	1 (1.6)	0	0	0
Vertigo					0	1 (7.1)	0	0

VPZ: Vonoprazan group; EPZ: Esomeprazole group; RPZ: Rabeprazole group; LPZ: Lansoprazole group.