Abstract
Efficacy of 7 day Vonoprazan VS 14 day PPI triple regimen in H. Pylori Infection Eradication; A Systematic Review and Meta-Analysis of Randomized Control Trials.
Yusi, Jan Axel MD, Francisco, Angelyka MD, Dungca, Audrey MD
Significance: Vonoprazan is a competitive potassium receptor blocker. Recent data showed that it is more efficacious in increasing gastric pH than PPI. Maximal acid inhibition has an important role in eliminating H. Pylori, a cure rate of 90% and above has been observed if the gastric acid pH is maintained above 4. The objective of this study is to assess the efficacy of a 7 day Vonoprazan based triple therapy in the eradication of H. Pylori vs a 14 day PPI based triple therapy.
Methodology: A comprehensive search through different online data base was done which included studies comparing a 7 day Vonprazan based Triple therapy (Vonoprazan, Calrithromycin, Amoxicillin) and 14 day PPI based regimen (PPI, Calrithromycin, Amoxicillin) in the eradication of H. Pylori infection. Inclusion and Exclusion criteria was made for the selection of studies. Three reviewers screened all articles, data collection was also done by them. Any disagreement was settled by majority vote. The Cochrane risk of bias tool was used to assess the presence of bias. Data was analysed using Revman5.4. The primary outcome that was measured was H. Pylori eradication, and the effect measure used was odds ratio with confidence interval of 95%.
Results: The search yielded 253 articles and 4 articles were included after applying the inclusion and exclusion criteria. There results showed that the 7 day Vonoprazan based triple therapy is superior to 14 day, OR 2.81 (95% CI 1.15,6.87) (pooled eradication rate 91.4% vs 77.8%); with a pvalue <0.5 which is statistically significant. I2 revealed considerable heterogeneity among studies.
Conclusion: In adult patients who are naïve to H. Pylroi eradication therapy, a 7 day Vonoprazan based triple therapy has superior eradication rates compared to a 14 day PPI based triple therapy.
Important Dates to Remember
| JRRE Activities 2023-2024 |
Proposed Dates |
|---|---|
| Resumption of face-to-face Evidence-Based Medicine Workshop Venue to be announced once finalized. |
July 21, 2023 (Friday), 1-5pm |
| Monthly Critical Appraisal of Topics Conferences to be gaciliated by Research Coordinators per Institution | Monthly Critical Appraisal of Topics Conferences per Institution |
| CAT Plenary/Liver Con Dates: September 23, 2023 December 16, 2023 March 2024 (During the JAC) Resumption of face-to-face Quarterly Critical Appraisal of Topics facilitated by the JRRE |
2 Clinical scenarios and articles are to be sent to institutions each on August 2023, November 2023, and February 2024; |
| Hybrid Research Workshop 4 week asynchronous via Moodle, followed by a 1 day on-site Onsite Workshop Research Protocol Presentation for Level I GI Fellows-In-Training - Research Protocol Presentation: August 12, 2023 - Research Forums of the Tripartite Societies |
Week 1: July 15-21, 2023 Week 2: July 22-28, 2023 Week 3: July 29-August 4, 2023 Week 4: August 5-11, 2023 |
| Research Manuscript Workshop for level II GI Fellows-In-Training | January 6, 2024 |