Background and aim Helicobacter pylori infection is a prevalent chronic bacterial infection in the world, involving approximately half of the world population. We aimed to evaluate and compare the efficacy and safety of vonoprazan (VPZ) versus omeprazole when used in a nonbismuth quadruple regimen for H. pylori eradication. Patients and methods In this prospective, open-label, randomized controlled trial, 200 individuals with dyspeptic symptoms and confirmed H. pylori infection were included from the outpatient clinic of the Hepatology and Gastroenterology Department at Al-Azhar Assiut University Hospital. Participants were randomized into two groups: group I ( n =100) received clarithromycin 500 mg twice daily, amoxicillin 1000 mg twice daily, nitazoxanide 500 mg twice daily, and omeprazole 40 mg twice daily for 14 days. Group II ( n =100) received the same antibiotic regimen combined with VPZ 20 mg twice daily for 14 days. Results The overall eradication rate was 85%, with a statistically significant difference between the two groups ( P =0.001). The VPZ-based regimen achieved a 94% eradication rate, significantly higher than the 76% noted with the omeprazole-based regimen. Conclusion VPZ-based therapy exhibited superior efficacy in eradicating H. pylori compared with omeprazole, with eradication rates of 94 versus 76%, respectively. The findings suggest that VPZ-based nonbismuth quadruple therapy is a safe, well-tolerated, and highly effective treatment option, offering improved success rates over traditional omeprazole-based regimens.
Tawfik et al. (Thu,) studied this question.