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However, uncertainties exist about the effectiveness and safety of VPZ\u2010based regimens compared with those of bismuth\u2010based quadruple therapy in eradicating <jats:italic>H. pylori<\/jats:italic>. The present meta\u2010analysis was performed to compare the effectiveness and safety of vonoprazan\u2010based regimens with those of bismuth quadruple therapy in eradicating <jats:italic>H. pylori<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>All randomized controlled trials and non\u2010randomized controlled trials comparing the vonoprazan\u2010based therapy with the bismuth quadruple therapy were included in this meta\u2010analysis. Information was also extracted by two evaluators, and if heterogeneity existed, a random\u2010effects model was used to calculate the combined relative ratio and 95% confidence interval; otherwise, a fixed\u2010effects model was used. And subgroup analyses were performed to explore the sources of heterogeneity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 10 studies, comprising 2587 patients were included in the meta\u2010analysis. The results showed that the combined eradication rate of patients treated with the vonoprazan\u2010based regimen was significantly higher than that of patients treated with bismuth quadruple therapy, in both intention\u2010to\u2010treat and per\u2010protocol analyses, and the differences were statistically significant. Among the intention\u2010to\u2010treat analyses results: (90.28% vs. 83.64% [odds ratio (OR)\u2009=\u20091.85, 95% confidence interval (CI) (1.27, 2.70), <jats:italic>p<\/jats:italic>\u2009=\u20090.001]); in the per\u2010protocol analyses: (94.80% vs. 89.88%, [OR\u2009=\u20092.25, 95% CI (1.37, 3.69), <jats:italic>p<\/jats:italic>\u2009=\u20090.001]). The occurrence of adverse events was significantly lower in patients treated with vonoprazan\u2010based regimens than in those treated with bismuth quadruple therapy, (14.50% vs. 25.89%, [OR\u2009=\u20090.49, 95% CI (0.32, 0.75), <jats:italic>p<\/jats:italic>\u2009=\u20090.001]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>For eradicating <jats:italic>H. pylori<\/jats:italic>, vonoprazan\u2010based regimens are remarkably advantageous over bismuth quadruple therapy. Furthermore, vonoprazan\u2010based regimens exhibit a lower rate of adverse events than bismuth quadruple therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hel.13059","type":"journal-article","created":{"date-parts":[[2024,3,6]],"date-time":"2024-03-06T03:53:52Z","timestamp":1709697232000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Meta\u2010analysis of <i>Helicobacter pylori<\/i> eradication therapy using vonoprazan as an acid suppressor compared with bismuth quadruple therapy"],"prefix":"10.1111","volume":"29","author":[{"given":"Hui","family":"Yang","sequence":"first","affiliation":[{"name":"State Key Laboratory of Cancer Biology, Xijing Hospital of Digestive Diseases The Fourth Military Medical University  Xi'an China"},{"name":"Yan'an University School of Medicine  Yan'an Shaanxi China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miao","family":"Zhang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Cancer Biology, Xijing Hospital of Digestive Diseases The Fourth Military Medical University  Xi'an China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gang","family":"Ma","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Cancer Biology, Xijing Hospital of Digestive Diseases The Fourth Military Medical University  Xi'an China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiaqi","family":"Yang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Cancer Biology, Xijing Hospital of Digestive Diseases The Fourth Military Medical University  Xi'an China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kemei","family":"Wang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Cancer Biology, Xijing Hospital of 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