{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T17:36:28Z","timestamp":1790876188148,"version":"4.1.0"},"reference-count":41,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,7,13]],"date-time":"2025-07-13T00:00:00Z","timestamp":1752364800000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"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"}]},{"DOI":"10.13039\/501100017531","name":"Medical and Health Research Project of Zhejiang Province","doi-asserted-by":"publisher","award":["2024XY170"],"award-info":[{"award-number":["2024XY170"]}],"id":[{"id":"10.13039\/501100017531","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2025,7]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n \n Rescue treatment for non\u2010naive patients with persistent\n \n Helicobacter pylori<\/jats:italic>\n <\/jats:styled-content>\n (\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n ) infection is lacking, especially in areas where tetracycline is unavailable. This trial aimed to evaluate the efficacy and safety of replacing proton pump inhibitor (PPI) with potassium\u2010competitive acid blocker (P\u2010CAB) in bismuth quadruple therapy (BQT) containing amoxicillin and furazolidone as rescue therapy.\n <\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n \n We conducted a prospective, open\u2010label, noninferiority randomized controlled trial at six institutions in eastern China. A total of 444 patients with a history of\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n treatment failure were enrolled and randomly assigned in a 1:1 ratio to either the 14\u2010day P\u2010CAB\u2010BQT group (vonoprazan 20\u2009mg, colloidal bismuth 200\u2009mg, amoxicillin 1000\u2009mg and furazolidone 100\u2009mg, all given twice daily) or the 14\u2010day PPI\u2010BQT group (rabeprazole 10\u2009mg given twice daily, and the same dose of three other drugs as the 14\u2010day P\u2010CAB\u2010BQT group). The primary endpoint was the eradication rate assessed by\n 13<\/jats:sup>\n C urea breath test. The secondary endpoints were adverse events and compliance.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n eradication rates of PPI\u2010BQT versus P\u2010CAB\u2010BQT group were 83.8% versus 91.9% in the intention\u2010to\u2010treat (ITT) analysis (treatment difference: 8.1%; 95% CI: 2.1%\u201314.1%; non\u2010inferiority\n p<\/jats:italic>\n \u2009<\u20090.001,\n p<\/jats:italic>\n \u2010value for difference\u2009=\u20090.008); 86.1% versus 95.8% in the modified ITT (MITT) analysis (treatment difference: 9.7%; 95% CI: 4.4%\u201315.0%; non\u2010inferiority\n p<\/jats:italic>\n \u2009<\u20090.001,\n p<\/jats:italic>\n \u2010value for difference <\u20090.001); and 86.3% versus 95.6% in the per\u2010protocol (PP) analysis (treatment difference: 9.3%; 95% CI: 3.8%\u201314.8%; non\u2010inferiority\n p<\/jats:italic>\n \u2009<\u20090.001,\n p<\/jats:italic>\n \u2010value for difference <\u20090.001). The P\u2010CAB\u2010BQT regimen was shown to be non\u2010inferior to the PPI\u2010BQT regimen and yielded higher eradication rates across all analysis populations (ITT, MITT, and PP). The overall frequency of adverse events (27.9% and 34.2%,\n p<\/jats:italic>\n \u2009=\u20090.151) and compliance (93.7% and 94.6%,\n p<\/jats:italic>\n \u2009=\u20090.686) were similar between PPI and P\u2010CAB groups. Among the patients suspected of drug\u2010induced fever (8.6% and 7.2%,\n p<\/jats:italic>\n \u2009=\u20090.597), 82.9% experienced fever after administration of furazolidone for >\u200910\u2009days. The eradication rates were not affected by prior choice of antibiotics and the number of treatment attempts.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n The 14\u2010day P\u2010CAB\u2010BQT therapy containing amoxicillin and furazolidone provided a satisfactory eradication rate and a good safety profile as rescue treatment for\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n eradication, regardless of prior choice of antibiotics and the number of treatment attempts. Shortening the treatment course to 10\u201311\u2009days could prevent the majority of drug\u2010induced fevers.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/hel.70056","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T04:19:52Z","timestamp":1752466792000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Vonoprazan Improves Efficacy of Bismuth Quadruple Therapy for\n \n Helicobacter pylori<\/i>\n <\/scp>\n Rescue Treatment: A Multicenter Randomized Controlled Trial"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2322-5029","authenticated-orcid":false,"given":"Tian\u2010Lian","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 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2198-2659","authenticated-orcid":false,"given":"Jing\u2010Hua","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 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren\u2010Ke","family":"Zhu","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 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao\u2010Liang","family":"Zhai","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Haining People's Hospital Haining 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Provincial Clinical Research Center for Digestive Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Ma","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 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin\u2010Jue","family":"He","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 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie\u2010Wei","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 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian\u2010Guo","family":"Gao","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 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling\u2010Ling","family":"Jiang","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 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kefang","family":"Sun","sequence":"additional","affiliation":[{"name":"Internal Medicine Residency Program Rochester General Hospital Rochester New York 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