Vonoprazan/high-dose Amoxicillin dual therapy is safe first-line therapy for H. pylori eradication

Vonoprazan 20 mg twice daily along with Amoxicillin 500 mg four times daily dual therapy is a safe standard first-line therapy for H. pylori elimination. The effectiveness and safety of Vonoprazan and high-dose (500 mg four times daily, 2000 mg/day) Amoxicillin dual therapy for the treatment of H. pylori has not yet been evaluated in an interventional trial. This prospective, dual-center, single-arm interventional trial sought to investigate whether this was a suitable first-line therapy.

Twenty H. pylori-positive individuals with no prior history of eradication received a 7-day course of treatment that included 20 mg Vonoprazan twice daily and 500 mg Amoxicillin four times daily. A test for H. pylori antigen in the stool was used to determine eradication. Using patient questionnaires, safety was assessed. The intention-to-treat (ITT) and per-protocol (PP) eradication rates are shown in Table 1:

No significant adverse event was noted. Thus, dual therapy using Vonoprazan and high-dose Amoxicillin appears to be a safe first-line treatment.