ArticleGut pathogens2025
Vonoprazan vs. high-dose esomeprazole in bismuth-containing quadruple therapy for Helicobacter pylori rescue treatment: a retrospective cohort study.
Article in Gut pathogens, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Evaluation of eradication efficacy and optimization strategies forFrontiers in medicine · 2026Article
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5 authors.
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Abstract
backgroundThe real-world comparative effectiveness study aimed to compare the effectiveness of vonoprazan (VON)-based therapy with high-dose esomeprazole (ESO)-based therapy in the re-eradication of Helicobacter pylori.
methodsThis real-world retrospective study analyzed patients at Nanjing First Hospital undergoing H. pylori re-eradication, who received either vonoprazan-based (VON) or high-dose esomeprazole-based (ESO) quadruple therapy. Both regimens included amoxicillin, furazolidone, and bismuth, administered twice daily for 14 days. Treatment strategies were determined by routine clinical practice, using either culture results or local epidemiological data. Patients were further classified into individualized precision (VON-P, ESO-P) or empirical (VON-E, ESO-E) groups based on real-world clinical decision-making.
resultsThe H. pylori re-eradication rates were 89.2% (191/214, 95% CI: 84.4-92.7%) in group ESO and 86.0% (98/114, 95% CI: 78.4-91.2%) in group VON, with no statistically significant difference between groups (P = 0.381). Among patients receiving individualized precision treatment, the re-eradication rates were 87.3% (62/71, 95%CI: 77.6-93.2%) for group ESO-P and 86.9% (53/61, 95% CI: 76.2-93.2%) for group VON-P, with no significant difference observed (P = 0.940). Similarly, for patients undergoing empirical treatment, there was no statistically significant difference in re-eradication rates between group ESO-E and group VON-E (90.2%, 129/143, 95% CI: 84.2-94.1% vs. 84.9%, 45/53, 95% CI: 72.9-92.1%; P = 0.296). Additionally, no significant difference was found between group ESO-E and group ESO-P (90.2%, 129/143, 95% CI: 84.2-94.1% vs. 87.3%, 62/71, 95% CI: 77.6-93.2%; P = 0.521), nor between group VON-E and group VON-P (84.9%, 45/53, 95% CI: 72.9-92.1% vs. 86.9%, 53/61, 76.2-93.2%; P = 0.762).
conclusionsBoth high-dose esomeprazole-containing quadruple therapy and VON-containing quadruple therapy have demonstrated effective as rescue treatments for H. pylori infection. Additionally, antibiotic selection informed by local epidemiological data demonstrated comparable effective to culture-based methods in this cohort, though future large-scale studies are needed to validate its generalizability.
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