Eradication of Helicobacter pylori With Vonoprazan-Amoxicillin Dual Therapy as an Alternative for Bismuth-Based Quadruple Therapy: A Systematic Review and Noninferiority Meta-Analysis.
Pedro Robson Costa Passos, Valbert Oliveira Costa Filho, Mariana Macambira Noronha et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the efficacy of vonoprazan-amoxicillin dual therapy (VADT) for Helicobacter pylori eradication compared to bismuth-based quadruple therapy (BQT) in 5866 participants from 18 randomized controlled trials. VADT demonstrated a +2.27% increase in eradication rates compared to BQT, with a posterior probability of noninferiority exceeding 99% for the -10% and -5% margins.
Key findings
- VADT achieved an absolute eradication increase of +2.27% compared to BQT in intention-to-treat analyses.
- Noninferiority probabilities for VADT exceeded 99% for -10% and -5% margins in per-protocol analyses.
- VADT was associated with significantly lower rates of dysgeusia, dizziness/headache, and nausea/vomiting.
Why it matters
The findings suggest that VADT may be an effective alternative for H. pylori eradication, particularly in East Asian populations where treatment tolerability and simplicity are prioritized. However, the evidence may not be applicable to Western populations.