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This contrasts with Western guidelines recommending 2\u2010week PPI\u2010based triple therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To verify the non\u2010inferiority of 1\u2010week vonoprazan\u2010based triple therapy versus 2\u2010week PPI\u2010based triple therapy as first\u2010line <jats:italic>H. pylori<\/jats:italic> eradication in a multiracial Asian cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Randomised controlled trial of treatment\u2010na\u00efve patients with <jats:italic>H. pylori<\/jats:italic> infection assigned 1:1 to either 7\u2009days amoxicillin 1\u00a0g\u2009+\u2009clarithromycin 500\u2009mg\u2009+\u2009vonoprazan 20\u2009mg twice per day or 14\u2009days amoxicillin 1\u00a0g\u2009+\u2009clarithromycin 500\u2009mg\u2009+\u2009omeprazole OR esomeprazole OR rabeprazole 20\u2009mg twice\/day. Subjects were randomly assigned to each PPI 1:1:1 Demographics, <jats:italic>H. pylori<\/jats:italic> resistance, CYP 2C19 genotype, eradication success and safety profiles were compared between groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between June 2019 and June 2021, 252 of 1097 subjects screened were randomised. 244 (age [SD] 51.7 [14.6]) received vonoprazan\u2010 (<jats:italic>n<\/jats:italic>\u00a0=\u2009119) or PPI\u2010based (<jats:italic>n<\/jats:italic>\u00a0=\u2009125) triple therapy. Eradication rates by intention\u2010to\u2010treat analysis were 87.4% (vonoprazan\u2010based triple therapy) versus 88.0% (PPI\u2010based triple therapy. By per protocol analysis: 96.3% (vonoprazan\u2010based triple therapy) versus 94.0% (PPI\u2010based triple therapy). Clarithromycin resistance predicted treatment failure on multivariate analysis: RR 11.4; 95% CI [1.4\u201396.3], <jats:italic>p<\/jats:italic>\u00a0=\u20090.025. No significant differences in CYP 2C19 genotypes or adverse events occurred between groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>One\u2010week vonoprazan\u2010based triple therapy achieved comparable efficacy to 2\u2010week PPI\u2010based triple therapy and was well tolerated.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.17070","type":"journal-article","created":{"date-parts":[[2022,6,4]],"date-time":"2022-06-04T04:06:48Z","timestamp":1654315608000},"page":"436-449","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":62,"title":["Clinical trial: seven\u2010day vonoprazan\u2010 versus 14\u2010day proton pump inhibitor\u2010based triple therapy for first\u2010line <i>Helicobacter pylori<\/i> 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