{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T20:44:55Z","timestamp":1783802695733,"version":"3.55.0"},"reference-count":33,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T00:00:00Z","timestamp":1694995200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Vonoprazan\u2010containing <jats:italic>Helicobacter pylori<\/jats:italic> eradication is reliably effective in Japan. Its effectiveness in other countries remains unclear. Here, we examined vonoprazan\u2010<jats:italic>H. pylori<\/jats:italic> therapies in Thailand.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>This was pilot study of four different vonoprazan containing therapies. Subjects were randomized to: 14\u2010day dual therapy (500\u2009mg amoxicillin q.i.d. plus 20\u2009mg vonoprazan b.i.d.), 14\u2010day triple therapy (amoxicillin 1\u2009g b.i.d., slow release clarithromycin\u2010MR, 1\u2009g daily plus vonoprazan 20\u2009mg b.i.d.), 7\u2010day high\u2010dose vonoprazan triple therapy (amoxicillin 1\u2009g b.i.d., clarithromycin\u2010MR 1\u2009g daily and 60\u2009mg vonoprazan once daily), and 14\u2010day vonoprazan triple therapy plus bismuth (amoxicillin 1\u2009g b.i.d., clarithromycin\u2010MR 1\u2009g daily, vonoprazan 20\u2009mg b.i.d., and bismuth subsalicylate 1048\u2009mg b.i.d.). Eradication was confirmed 4\u2009weeks after therapy. Antimicrobial susceptibility and CYP3A4\/5 genotyping were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred <jats:italic>H. pylori\u2010<\/jats:italic>infected patients (mean age 54.3\u2009\u00b1\u200913\u2009years, 51% men) were randomized. All were CYP3A4 extensive metabolizers. Cure rates with both 14\u2010day vonoprazan dual therapy and 14\u2010day triple therapy were low: 66.7%; 95% CI\u2009=\u200943\u201385% (14\/21), and 59.3%; 95% CI\u2009=\u200939\u201378%) (16\/27), respectively. In contrast, 7\u2010day high\u2010dose vonoprazan triple therapy and 14\u2010day vonoprazan triple plus bismuth proved effective 92.3%; 95% CI\u2009=\u200975%\u201399% (24\/26) and 96.2%; 95% CI\u2009=\u200980%\u2013100% (25\/26), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Both 14\u2010day vonoprazan dual and triple therapy were ineffective for <jats:italic>H. pylori<\/jats:italic> eradication in Thailand. Higher dosage of vonoprazan, and\/or the addition of bismuth may be required to achieve high <jats:italic>H. pylori<\/jats:italic> eradication rates. High\u2010dose vonoprazan triple therapy and vonoprazan triple therapy adding bismuth might be used as first\u2010line treatments in some regions with high efficacy irrespective of CYP3A4\/5 genotype and clarithromycin resistance.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hel.13019","type":"journal-article","created":{"date-parts":[[2023,9,19]],"date-time":"2023-09-19T03:05:47Z","timestamp":1695092747000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Pilot studies of vonoprazan\u2010containing <i>Helicobacter pylori<\/i> eradication therapy suggest Thailand may be more similar to the <scp>US<\/scp> than Japan"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6442-0838","authenticated-orcid":false,"given":"Sarita","family":"Ratana\u2010Amornpin","sequence":"first","affiliation":[{"name":"Center of excellence in Digestive Diseases and Gastroenterology Unit, Department of Medicine, Faculty of Medicine Thammasat University Hospital  Pathumthani Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Likasith","family":"Sanglutong","sequence":"additional","affiliation":[{"name":"Center of excellence in Digestive Diseases and Gastroenterology Unit, Department of Medicine, Faculty of Medicine Thammasat University Hospital  Pathumthani Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thanee","family":"Eiamsitrakoon","sequence":"additional","affiliation":[{"name":"Department of Medicine Chulabhorn International College of Medicine (CICM) at Thammasat University  Pathumthani Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9842-3025","authenticated-orcid":false,"given":"Sith","family":"Siramolpiwat","sequence":"additional","affiliation":[{"name":"Center of excellence in Digestive Diseases and Gastroenterology Unit, Department of Medicine, Faculty of Medicine Thammasat University Hospital  Pathumthani Thailand"},{"name":"Department of Medicine Chulabhorn International College of Medicine (CICM) at Thammasat University  Pathumthani Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6908-8317","authenticated-orcid":false,"given":"David Y.","family":"Graham","sequence":"additional","affiliation":[{"name":"Department of Medicine Michael E. 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