{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T01:25:11Z","timestamp":1787966711743,"version":"build-2784847793"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,6,7]],"date-time":"2025-06-07T00:00:00Z","timestamp":1749254400000},"content-version":"vor","delay-in-days":37,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Limited research has explored the efficacy of reduced amoxicillin dosages in vonoprazan\u2010amoxicillin (VA) dual therapy for <jats:styled-content style=\"fixed-case\"><jats:italic>Helicobacter pylori<\/jats:italic><\/jats:styled-content> eradication in China, and this study aimed to assess the noninferiority of these lower dosages compared to the standard high dose (3\u2009g\/d).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a noninferiority study with a \u221210% margin. <jats:styled-content style=\"fixed-case\"><jats:italic>H. pylori<\/jats:italic><\/jats:styled-content>\u2010positive patients from 13 centers in Jiangsu Province, China, were randomly assigned in a 1:1:1 ratio to receive a 14\u2010day treatment, consisting of vonoprazan (20\u2009mg BID) and high\u2010dose amoxicillin (1\u2009g TID, HVA), medium\u2010dose amoxicillin (1\u2009g BID, MVA), or low\u2010dose amoxicillin (0.5\u2009g TID, LVA). The eradication rates, adverse events (AEs), and medication adherence were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From January 13, 2023 to July 6, 2024, a total of 900 patients were enrolled. According to the intention\u2010to\u2010treat (ITT) and per\u2010protocol (PP) analyses, the eradication rates for HVA, MVA, and LVA groups were 93.2% and 93.2%, 91.6% and 91.5%, and 87.0% and 86.8%, respectively. The efficacy of MVA was noninferior to HVA in ITT analysis (difference: \u22121.6%, 97.5% CI: \u22127.0% to 3.8%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and PP analysis (difference: \u22121.7%, 97.5% CI: \u22127.1% to 3.7%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001); LVA's effectiveness was less than HVA in ITT analysis (difference: \u22126.2%, 97.5% CI: \u221212.2% to \u22120.2%, <jats:italic>p<\/jats:italic>\u2009=\u20090.076) and PP analysis (difference:\u20106.4%, 97.5% CI: \u221212.4% to \u22120.3%, <jats:italic>p<\/jats:italic>\u2009=\u20090.089). The incidence of AEs and medication compliance among the three groups was similar.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A 14\u2010day VA regimen requires \u2265\u20092\u2009g\/d amoxicillin to maintain noninferior eradication efficacy versus 3\u2009g\/d, supporting dose reduction without compromising effectiveness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p>ClinicalTrials.gov identifier: NCT05649540<\/jats:p><\/jats:sec>","DOI":"10.1111\/hel.70050","type":"journal-article","created":{"date-parts":[[2025,6,7]],"date-time":"2025-06-07T06:34:42Z","timestamp":1749278082000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Efficacy of Three Amoxicillin Doses in Vonoprazan Dual Therapy for <scp><i>Helicobacter pylori<\/i><\/scp> Eradication: A Randomized Noninferiority Trial"],"prefix":"10.1111","volume":"30","author":[{"given":"Ruolin","family":"Peng","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Nanjing First Hospital, Nanjing Medical University  Nanjing Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pengpeng","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Sir Run Run Hospital, Nanjing Medical University  Nanjing Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6712-5708","authenticated-orcid":false,"given":"Zhimei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The First People's Hospital of Lianyungang  Lianyungang Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4378-0962","authenticated-orcid":false,"given":"Shengxiang","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The First People's Hospital of Lianyungang  Lianyungang Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangxia","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The First People's Hospital of Xuzhou, Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University  Xuzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuling","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The First People's Hospital of Xuzhou, Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University  Xuzhou Jiangsu 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