Efficacy and Safety of Vonoprazan and High-Dose Amoxicillin Dual Therapy for Rescue Treatment of Helicobacter pylori Infection: A Multicenter Randomized Controlled Trial

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Conflicts of Interest

Identified Weaknesses

Rating Explanation

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Paper Summary

Paperzilla title

Double-Dose Vonoprazan Plus Amoxicillin: A Gentler Stomach Bug Rescue Mission

This study found that a 14-day dual therapy of vonoprazan and high-dose amoxicillin (VHA) was as effective as the standard bismuth-containing quadruple therapy (BQT) for treating persistent H. pylori infection after initial treatment failure. Importantly, the VHA therapy resulted in significantly fewer side effects. Further research is needed to confirm these results in diverse populations and evaluate the role of antibiotic resistance testing.

Possible Conflicts of Interest

The authors declare no conflicts of interest.

Identified Weaknesses

Limited Generalizability

Regional variations in H. pylori resistance and dietary habits in China may limit the generalizability of these findings to other populations.

Suboptimal Control Group

The control group received standard TFEB therapy without prior antimicrobial susceptibility testing, reflecting common practice but potentially impacting the efficacy comparison.

Open-Label Design

The open-label design, lacking blinding, may have introduced bias in the reporting of adverse events.

Inconsistent Testing Methods

Different H. pylori testing methods were used, potentially affecting the accuracy and reliability of the results.

Exclusion of Allergic Patients

Patients with amoxicillin allergies were excluded, limiting the applicability of the findings to this specific population.

Rating Explanation

This is a well-designed multicenter RCT with a clear methodology and substantial sample size. While limited by its regional focus and open-label design, the findings are valuable and contribute significantly to our understanding of H. pylori rescue treatment options. The lower incidence of adverse events with VHA is a clinically important advantage.

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Topic Hierarchy

Domain:

Health Sciences

Field:

Medicine

Subfield:

Gastroenterology

File Information

Original Title:

Efficacy and Safety of Vonoprazan and High-Dose Amoxicillin Dual Therapy for Rescue Treatment of Helicobacter pylori Infection: A Multicenter Randomized Controlled Trial

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August 20, 2025 at 03:25 PM

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