7‐day versus 14‐day tegoprazan‐based triple therapy to treat Helicobacter pylori infection: Real‐world evidence

• Published in: Journal of gastroenterology and hepatology Vol. 37; no. 10; pp. 1911 - 1918
• Main Authors: Jung, Yoon Suk, Kim, Sunyong, Kim, Hyun‐Young, Noh, Seung Jae, Park, Jung Ho, Park, Chan Hyuk
• Format: Journal Article
• Language: English
• Published: Richmond Wiley Subscription Services, Inc 01.10.2022
• Subjects: Amoxicillin; Clarithromycin; duration; Eradication; H. pylori; Helicobacter pylori; Infections; Patients; P‐CAB; tegoprazan
• ISSN: 0815-9319; 1440-1746
• DOI: 10.1111/jgh.15939

Background and Aim Potassium‐competitive acid blockers (P‐CABs) can be used to eradicate Helicobacter pylori infection. We aimed to evaluate the impact of treatment duration (7 vs 14 days) on successful H. pylori eradication with P‐CAB‐based triple therapy in Korea, where clarithromycin resistance rate is high. Methods We retrospectively reviewed the data of patients who received first‐line treatment for H. pylori infection with tegoprazan‐based triple therapy (50 mg tegoprazan + 1000 mg amoxicillin + 500 mg clarithromycin twice daily for 1 or 2 weeks). The primary endpoint was the eradication rate in intention‐to‐treat (ITT) analysis. Results Of the 948 patients included in the study, 435 and 513 received 7‐day and 14‐day tegoprazan‐based triple therapy, respectively. The eradication rate was higher in the 14‐day therapy group than in the 7‐day therapy group (ITT, 63.9%; 95% confidence interval [CI], 59.3–68.3%] vs 78.6% [95% CI, 74.9–81.9%], respectively, P < 0.001; per‐protocol, 70.5% [95% CI, 65.8–74.8%] vs 85.1% [81.7–88.1%], respectively, P < 0.001). Overall adverse event rates did not differ between the two groups. Although six patients in the 14‐day treatment group discontinued the prescribed medications due to adverse events, four of them (67%) discontinued the medication within 4 days. Conclusions The 14‐day tegoprazan‐based triple therapy showed a superior eradication rate and acceptable adverse events compared with the 7‐day tegoprazan‐based triple therapy. A 14‐day treatment regimen may be required when H. pylori infection is treated with tegoprazan‐based triple therapy in regions with high clarithromycin resistance.