{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T23:15:37Z","timestamp":1792278937996,"version":"4.4.0"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T00:00:00Z","timestamp":1741219200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81600447"],"award-info":[{"award-number":["81600447"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81970498"],"award-info":[{"award-number":["81970498"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004731","name":"Natural Science Foundation of Zhejiang Province","doi-asserted-by":"publisher","award":["LZ22H030002"],"award-info":[{"award-number":["LZ22H030002"]}],"id":[{"id":"10.13039\/501100004731","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Helicobacter pylori eradication in penicillin-allergic patients presents challenges. Options of effective regimens are lacking in areas where tetracycline is unavailable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the efficacy of replacing the proton pump inhibitor (PPI) with a potassium-competitive acid blocker (P-CAB, vonoprazan) in standard bismuth quadruple therapy containing doxycycline and metronidazole as a first-line treatment for H. pylori.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective randomized clinical trial enrolled 332 naive patients with H. pylori infection and penicillin allergy. Participants were randomly assigned in a 1:1 ratio to either the 14\u2005day P-CAB\/BDM group (vonoprazan 20\u2005mg twice daily, colloidal bismuth 200\u2005mg twice daily, doxycycline 100\u2005mg twice daily and metronidazole 400\u2005mg three times daily) or the 14\u2005day PPI\/BDM group (rabeprazole 10\u2005mg twice daily, and the same dose of the three other drugs as in the 14\u2005day P-CAB\/BDM group).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eradication rates in the P-CAB\/BDM and PPI\/BDM groups were 90.4% and 71.1% (P value for superiority was 0.013), respectively, by ITT analysis. The efficacy of P-CAB\/BDM remained non-inferior and even superior to PPI\/BDM therapy in all ITT, modified ITT and PP analyses. The overall frequency of adverse events (39.8% and 40.4%; P\u200a=\u200a0.911) and compliance (88.0% and 91.0%; P\u200a=\u200a0.372) were similar between P-CAB and PPI regimens. Patients with higher body surface area were significantly associated with eradication failure in both groups (P\u200a&amp;lt;\u200a0.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The 14\u2005day P-CAB\/BDM therapy provided a satisfactory eradication rate of &amp;gt;90% (ITT analysis) and had a good safety profile as first-line H. pylori therapy, providing an alternative option for penicillin-allergic patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkae467","type":"journal-article","created":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T15:15:00Z","timestamp":1740842100000},"page":"927-934","source":"Crossref","is-referenced-by-count":9,"title":["Vonoprazan improves the efficacy of bismuth quadruple therapy containing doxycycline and metronidazole as first-line\n                    <i>Helicobacter pylori<\/i>\n                    treatment in penicillin-allergic patients: a randomized controlled trial"],"prefix":"10.1093","volume":"80","author":[{"given":"Tianlian","family":"Yan","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Zhejiang Provincial Clinical Research Center for Digestive Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou 310003 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinghua","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Zhejiang Provincial Clinical Research Center for Digestive Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou 310003 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renke","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Zhejiang Provincial Clinical Research Center for Digestive Diseases, The First Affiliated 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Digestive Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou 310003 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Mathematics and Statistics, Northern Arizona University , Flagstaff, AZ 86011 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kefang","family":"Sun","sequence":"additional","affiliation":[{"name":"Internal Medicine Residency Program, Rochester General Hospital , Rochester, NY 14621 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Endoscopy Center, The First Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou 310003 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