Vonoprazan-based therapy for <i>Helicobacter pylori</i> eradication: experience and clinical evidence

Akazawa, Yuko; Fukuda, Daisuke; Fukuda, Yutaka

doi:10.1177/1756283x16668093

Cited by 36 publications

(26 citation statements)

References 48 publications

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“…Selecting a PPI with high efficacy and less influence by CYP2C19 genotypes can improve the eradication rate . The new potassium‐competitive acid blocker (vonoprazan) has a stronger effect on inhibition of acid secretion, and its application is expected to further improve the eradication rate of H. pylori …”

Section: Treatmentmentioning

confidence: 99%

Fifth Chinese National Consensus Report on the management ofHelicobacter pyloriinfection

et al. 2018

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Section: Treatmentmentioning

confidence: 99%

Fifth Chinese National Consensus Report on the management ofHelicobacter pyloriinfection

et al. 2018

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“…11 Plasma half-life of 5.7 and 7 hours was reported for vonoprazan after a single 20 mg dose and on the seventh day of administration in humans, which are considerably longer than the plasma half-life of conventional PPIs (<2 h). 12 Importantly, as vonoprazan is mainly metabolized by CYP3A4, its acid inhibitory effect is least influenced by CYP2C19 polymorphisms. These features allow to this drug to exert rapid, strong, and stable inhibition of the proton pump.…”

Section: Novel Pharmacological Approach To Acid Inhibitionmentioning

confidence: 99%

“…Vonoprazan increases intragastric pH to over 4.0 within 4 hours after the first administration in humans, creating conditions in which amoxicillin and clarithromycin are stable. 12 Consequently, the intragastric pH greater than 5 holding time ratio was reported to be 99% with vonoprazan 20 mg twice daily compared to 84% with esomeprazole at 20 mg twice daily when administered for 7 days. 13 Taken together, these observations demonstrate the improved potential of vonoprazan for eradicating H. pylori compared with that of conventional PPIs.…”

Section: Novel Pharmacological Approach To Acid Inhibitionmentioning

confidence: 99%

“…54 Other Japanese studies have reported H. pylori eradication rates ranging from 88% to 94% using vonoprazan-based in first-line triple therapy. 12 The adverse effects of vonoprazan-based therapies are comparable to conventional short PPI-based eradication therapies, though long-term studies on the effects of vonoprazan are awaited. 12 The efficacy of vonoprazan after failure with first-line treatment is largely unknown.…”

Section: Third-line (And Beyond) Regimensmentioning

confidence: 99%

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Pharmacological considerations and step-by-step proposal for the treatment of Helicobacter pylori infection in the year 2018

Pellicano

Zagari

Zhang

et al. 2018

Minerva Gastroenterol Dietol

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Over the past 30 years, multidrug regimens consisting of a proton pump inhibitor (PPI) and two or three antibiotics have been used in treating Helicobacter pylori (H. pylori) infection. In clinical practice, the optimal regimen to cure H. pylori infection should be decided regionally. Considering the first treatment, the Maastricht V/Florence Consensus Report and the American College of Gastroenterology Clinical Management Guideline highlight that in countries with low clarithromycin resistance rates (<15%), an empiric clarithromycin-based regimen can be used. In countries with high clarithromycin resistance rates or, in the American Guideline, with a previous exposure to clarithromycin, a bismuth-containing quadruple therapy (with metronidazole and tetracycline) is the first choice. In case of persistent infection, after a previous clarithromycin-containing regimen, this drug should be avoided in second line therapy. Options after initial eradication failure include tailored therapy (choosing antibiotic combinations based on antibiotic susceptibility testing), empiric bismuthcontaining quadruple therapy or triple levofloxacin-based therapy. Encouraging data are reported, both for the first-line and for rescue treatments, with the use of a formulation of bismuth subcitrate potassium, metronidazole, and tetracycline contained in a single capsule, together with a PPI. Rifabutin-and furazolidone-based regimens should also be considered in rescue regimens. Vonoprazan, a new type of potassium-competitive acid blocker that produces more potent acid inhibition than PPIs, provides improved H. pylori eradication rates in combination with antibiotics. In this review, the authors provide an overview on the current knowledge on the treatment of H. pylori infection, with focus on therapeutic challenges in this field.

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“…Все описанные свойства позволяют К-КБК оказывать более длительный и быстрый антисекреторный эффект [36,38]. В рамках ЭТ использование К-КБК, зарегистрированного в Японии как вонопразан, позволяет повысить эффективность эрадикации на 16,7-18,2% по сравнению с использованием ИПП [39,40] [47]. Важно отметить, что увеличение дозы ИПП с энзиматическим путем метаболизма у «быстрых» метаболизаторов не гарантирует успеха в рамках ЭТ [26].…”

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Significance of adequate acid suppression as part of helicobacter pylori-associated disease therapy

Andreev¹,

Велиев²

2018

Med. sov.

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Д.Н. АНДРЕЕВ, к.м.н., А.М. ВЕЛИЕВ Московский государственный медико-стоматологический университет им. А.И. Евдокимова Минздрава России ЗНАЧЕНИЕ АДЕКВАТНОЙ КИСЛОТОСУПРЕССИИ В РАМКАХ ТЕРАПИИ HELICOBACTER PYLORI-АССОЦИИРОВАННЫХ ЗАБОЛЕВАНИЙ В статье систематизированы литературные данные о роли адекватной кислотосупрессии в рамках терапии Helicobacter pylori-ассоциированных заболеваний. Повышение уровня рН в желудке коррелирует с эффективностью проводимой эрадикационной терапии. Так, при более высоких значениях рН снижаются минимальные ингибирующие концентрации амоксициллина, кларитромицина и метронидазола, увеличивая чувствительность Helicobacter pylori к этим антибактериальным препаратам. Помимо этого, увеличение рН в желудке способствует повышению устойчивости ряда антибактериальных средств, что повышает вероятность успешной эрадикации микроорганизма. Ключевые слова:Helicobacter pylori, ингибиторы протонной помпы, рабепразол, эрадикационная терапия. D.N. ANDREEV, PhD in medicine, A.M. VELIEV Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of Russia SIGNIFICANCE OF ADEQUATE ACID SUPPRESSION AS PART OF HELICOBACTER PYLORI-ASSOCIATED DISEASE THERAPY The article presents a systematized review of the literature data on the role of adequate acid suppression in the treatment ofHelicobacter pylori-associated diseases. The increased pH levels in the stomach correlate with the efficacy of eradication therapy. Thus, minimal inhibitory concentrations of amoxicillin, clarithromycin and metronidazole decrease at higher pH levels, increasing the Helicobacter pylori sensitivity to these antibacterial drugs. In addition, the increased pH levels in the stomach contribute to the stability of some antibacterial agents, which increases the likelihood of eradication success.

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Vonoprazan-based therapy for Helicobacter pylori eradication: experience and clinical evidence

Cited by 36 publications

References 48 publications

Fifth Chinese National Consensus Report on the management ofHelicobacter pyloriinfection

Fifth Chinese National Consensus Report on the management ofHelicobacter pyloriinfection

Pharmacological considerations and step-by-step proposal for the treatment of Helicobacter pylori infection in the year 2018

Significance of adequate acid suppression as part of helicobacter pylori-associated disease therapy

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