PMID- 28098408
OWN - NLM
STAT- MEDLINE
DCOM- 20180205
LR  - 20220310
IS  - 1523-5378 (Electronic)
IS  - 1083-4389 (Linking)
VI  - 22
IP  - 3
DP  - 2017 Jun
TI  - Vonoprazan improves the efficacy of Helicobacter pylori eradication therapy with 
      a regimen consisting of clarithromycin and metronidazole in patients allergic to 
      penicillin.
LID - 10.1111/hel.12374 [doi]
AB  - BACKGROUND: Although all Helicobacter pylori (H. pylori)-positive patients should 
      receive eradication therapy, the therapy is a challenge for patients allergic to 
      penicillin. There have been a few reports on the efficacy of eradication therapy 
      for such patients. OBJECTIVE: To analyze the efficacy of vonoprazan or proton 
      pump inhibitor (PPI)-based 7-day triple therapy in patients allergic to 
      penicillin. MATERIALS AND METHODS: A total of 88 consecutive patients allergic to 
      penicillin who received H. pylori eradication therapy were retrospectively 
      analyzed. Thirty-one patients had a history of failed eradication therapy. Four 
      7-day regimens were prescribed during the study period: 
      clarithromycin-metronidazole-PPI (13 patients), 
      clarithromycin-metronidazole-vonoprazan (14 patients), 
      metronidazole-sitafloxacin-PPI (44 patients) and 
      metronidazole-sitafloxacin-vonoprazan (17 patients). A (13) C-urea breath test 
      was used for confirmation of eradication, and efficacy of eradication was 
      evaluated by "intention-to-treat" analysis and "per-protocol" analysis. RESULTS: 
      Intention-to-treat and per-protocol eradication rates were 46.2%/54.6% for 
      patients who received clarithromycin-metronidazole-PPI, 92.9/92.9% for patients 
      who received clarithromycin-metronidazole-vonoprazan, 100/100% for patients who 
      received metronidazole-sitafloxacin-PPI and 88.2/93.8% for patients who received 
      metronidazole-sitafloxacin-vonoprazan. For first eradication, vonoprazan 
      significantly raised the intention-to-treat efficacy of the triple therapy 
      including clarithromycin-metronidazole (vonoprazan: 92.9%, PPI: 46.2%, P=.0128). 
      A 7-day regimen consisting of metronidazole and sitafloxacin was effective for 
      patients allergic to penicillin with or without past failure of eradication. 
      CONCLUSION: For first eradication in patients allergic to penicillin, a 7-day 
      triple therapy consisting of clarithromycin, metronidazole and vonoprazan could 
      be a candidate eradication regimen.
CI  - (c) 2017 John Wiley & Sons Ltd.
FAU - Ono, Shoko
AU  - Ono S
AD  - Division of Endoscopy, Hokkaido University Hospital, Sapporo, Japan.
FAU - Kato, Mototsugu
AU  - Kato M
AD  - Department of Gastroenterology, National Hospital Organization Hakodate Hospital, 
      Hakodate, Japan.
FAU - Nakagawa, Soichi
AU  - Nakagawa S
AD  - Department of Gastroenterology, Hokkaido University Graduate School of Medicine, 
      Sapporo, Japan.
FAU - Mabe, Katsuhiro
AU  - Mabe K
AD  - Department of Gastroenterology, National Hospital Organization Hakodate Hospital, 
      Hakodate, Japan.
FAU - Sakamoto, Naoya
AU  - Sakamoto N
AD  - Department of Gastroenterology, Hokkaido University Graduate School of Medicine, 
      Sapporo, Japan.
LA  - eng
PT  - Journal Article
DEP - 20170118
PL  - England
TA  - Helicobacter
JT  - Helicobacter
JID - 9605411
RN  - 0 
      (1-(5-(2-fluorophenyl)-1-(pyridin-3-ylsulfonyl)-1H-pyrrol-3-yl)-N-methylmethanamine)
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Carbon Isotopes)
RN  - 0 (Pyrroles)
RN  - 0 (Sulfonamides)
RN  - 140QMO216E (Metronidazole)
RN  - 8W8T17847W (Urea)
RN  - H1250JIK0A (Clarithromycin)
SB  - IM
MH  - Anti-Bacterial Agents/*therapeutic use
MH  - Breath Tests
MH  - Carbon Isotopes/analysis
MH  - Clarithromycin/*therapeutic use
MH  - Female
MH  - Helicobacter Infections/*drug therapy
MH  - Helicobacter pylori/*drug effects
MH  - Humans
MH  - Hypersensitivity/complications
MH  - Male
MH  - Metronidazole/*therapeutic use
MH  - Middle Aged
MH  - Pyrroles/*therapeutic use
MH  - Retrospective Studies
MH  - Sulfonamides/*therapeutic use
MH  - Treatment Outcome
MH  - Urea/analysis
OTO - NOTNLM
OT  - Helicobacter pylori
OT  - eradication therapy
OT  - penicillin allergy
OT  - vonoprazan
EDAT- 2017/01/18 06:00
MHDA- 2018/02/06 06:00
CRDT- 2017/01/19 06:00
PHST- 2017/01/18 06:00 [pubmed]
PHST- 2018/02/06 06:00 [medline]
PHST- 2017/01/19 06:00 [entrez]
AID - 10.1111/hel.12374 [doi]
PST - ppublish
SO  - Helicobacter. 2017 Jun;22(3). doi: 10.1111/hel.12374. Epub 2017 Jan 18.