{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T04:19:14Z","timestamp":1788149954211,"version":"build-2803163510"},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":55,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100012553","name":"Chang Gung Memorial Hospital","doi-asserted-by":"publisher","award":["CMRPG8L1302"],"award-info":[{"award-number":["CMRPG8L1302"]}],"id":[{"id":"10.13039\/100012553","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005925","name":"Buddhist Tzu Chi Medical Foundation","doi-asserted-by":"publisher","award":["TCMF\u2010A 114\u201001"],"award-info":[{"award-number":["TCMF\u2010A 114\u201001"]}],"id":[{"id":"10.13039\/501100005925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2026,7]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n \n The eradication rate of amoxicillin\u2013vonoprazan (AV) dual therapy for\n \n Helicobacter pylori<\/jats:italic>\n <\/jats:styled-content>\n (\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n ) infection varies by region and is below 90% in both the United States and Taiwan. We recently added bismuth to this regimen, and the resulting bismuth\u2013amoxicillin\u2013vonoprazan (BAV) triple therapy achieved eradication rates \u2265\u200995% in Taiwan.\n <\/jats:p>\n <\/jats:sec>\n \n Aims<\/jats:title>\n \n To compare the efficacy and safety of 14\u2010day BAV triple therapy with AV dual therapy and clarithromycin\u2013amoxicillin\u2013rabeprazole (CAR) standard triple therapy as first\u2010line regimens for\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n eradication.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In this multicenter, randomized, open\u2010label trial, adults with\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n infection were randomized (1:1:1) to receive one of the following 14\u2010day regimens: BAV triple therapy (tripotassium dicitrato bismuthate 300\u2009mg four times daily, amoxicillin 750\u2009mg four times daily, and vonoprazan 20\u2009mg twice daily), AV dual therapy (vonoprazan 20\u2009mg twice daily and amoxicillin 750\u2009mg four times daily), or CAR standard triple therapy (rabeprazole 20\u2009mg, amoxicillin 1\u2009g, and clarithromycin 500\u2009mg twice daily). Eradication was assessed by the\n 13<\/jats:sup>\n C\u2010urea breath test. The primary endpoint was eradication in the intention\u2010to\u2010treat population.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Between November 2023 and June 2025, 390 patients were enrolled. Intention\u2010to\u2010treat eradication rates were 93.8% with BAV therapy, 83.8% with AV therapy, and 83.1% with CAR therapy. BAV therapy was superior to both AV therapy (95% CI, 2.4%\u201317.6%;\n p<\/jats:italic>\n \u2009=\u20090.010) and CAR therapy (95% CI, 3.0%\u201318.4%;\n p<\/jats:italic>\n \u2009=\u20090.007). Per\u2010protocol eradication rates were 97.5%, 88.3%, and 88.0%, respectively; BAV therapy remained superior to AP therapy (\n p<\/jats:italic>\n \u2009=\u20090.010) and CAR therapy (\n p<\/jats:italic>\n \u2009=\u20090.05). Overall adverse event rates (10.8%, 8.5%, and 13.8%) were comparable. Amoxicillin resistance and clarithromycin resistance were identified as risk factors for eradication failure with BAV and CAR therapies, respectively.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n BAV triple therapy demonstrates superior efficacy compared with AV dual therapy and CAR triple therapy as first\u2010line treatment for\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n infection in Taiwan. This regimen represents a promising first\u2010line option that may obviate the need for routine clarithromycin\u2010resistance testing in regions where AV dual therapy yields suboptimal eradication rates.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/hel.70131","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T11:42:54Z","timestamp":1787658174000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bismuth\u2013Amoxicillin\u2013Vonoprazan Triple, Amoxicillin\u2013Vonoprazan Dual, and Clarithromycin\u2010Based Triple Therapies for First\u2010Line Treatment of\n Helicobacter pylori<\/i>\n Infection: A Multicenter, Open\u2010Label, Randomized Trial"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3905-4674","authenticated-orcid":false,"given":"Ping\u2010I","family":"Hsu","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, An Nan Hospital China Medical University Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming\u2010Jen","family":"Sheu","sequence":"additional","affiliation":[{"name":"Division of Hepatogastroenterology, Department of Internal Medicine Chi Mei Medical Center Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9084-8210","authenticated-orcid":false,"given":"Chien\u2010Lin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Medicine, Buddhist Tzu Chi General Hospital Tzu Chi University Hualien Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei\u2010Yi","family":"Lei","sequence":"additional","affiliation":[{"name":"Department of Medicine, Buddhist Tzu Chi General Hospital Tzu Chi University Hualien Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0924-6544","authenticated-orcid":false,"given":"Chih\u2010An","family":"Shih","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, Antai Medical Care Corporation Antai Tian\u2010Sheng Memorial Hospital Pingtung City Taiwan"},{"name":"Department of Nursing Meiho University Pingtung County Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng\u2010Woei","family":"Tsay","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital National Yang\u2010Ming Chiao Tung University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung\u2010Shuo","family":"Kao","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Pingtung Veterans General Hospital National Yang\u2010Ming Chiao Tung University Pingtung City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang\u2010Bih","family":"Shie","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, An Nan Hospital China Medical University Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9055-571X","authenticated-orcid":false,"given":"Pei\u2010Jui","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Hepatogastroenterology, Department of Internal Medicine Chi Mei Medical Center Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao\u2010Hung","family":"Kuo","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital Kaohsiung Medical University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jyh\u2010Chin","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine National Taiwan University Hospital Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuan\u2010Yang","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei City Hospital Renai Branch Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8934-3223","authenticated-orcid":false,"given":"Seng\u2010Kee","family":"Chuah","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine Kaohsiung Chang Gung Memorial Hospital Kaohsiung Taiwan"},{"name":"College of Medicine Chang Gung University Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia\u2010Long","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine Cathay General Hospital Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsi\u2010Chang","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei City Hospital Renai Branch Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei\u2010Chen","family":"Tai","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine Kaohsiung Chang Gung Memorial Hospital Kaohsiung Taiwan"},{"name":"College of Medicine Chang Gung University Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tzung\u2010Jiun","family":"Tsai","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital National Yang\u2010Ming Chiao Tung University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John Y.","family":"Kao","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Michigan Medicine University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3742-0634","authenticated-orcid":false,"given":"Deng\u2010Chyang","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital Kaohsiung Medical University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Taiwan Acid\u2010related Disease & Microbiota (TARD\u2010M) Consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-023-00431-8"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1710945"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2022-327745"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000002968"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.13911"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2025-336027"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60020-2"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31409-X"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.15034"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(23)00281-9"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2025-335523"},{"key":"e_1_2_9_13_1","first-page":"365","article-title":"Campylobacter pylori\n \u2010Associated Gastritis: A Double\u2010Blind Placebo\u2010Controlled Trial With Amoxycillin","volume":"83","author":"Glupczynski Y.","year":"1988","journal-title":"American Journal of Gastroenterology"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12059"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2014.10.036"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms13040715"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000002255"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00033-06"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pharmthera.2016.08.001"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13588"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.15641"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/hel.70070"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000035610"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12970"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2022.05.055"},{"key":"e_1_2_9_26_1","article-title":"Vonoprazan High\u2010Dose Dual, Vonoprazan Triple and Rabeprazole Reverse Hybrid Therapies for First\u2010Line Treatment of H. pylori Infection: A Multicenter Randomized Trial","author":"Hsu P. I.","year":"2025","journal-title":"American Journal of Gastroenterology"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2015-311019"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1039\/c2mt00180b"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1039\/C8SC01668B"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(25)00898-0"},{"key":"e_1_2_9_31_1","article-title":"The Efficacy and Safety of High\u2010Dose Amoxicillin\u2013Bismuth\u2010Potassium Competitive Acid Blocker Therapy for \n Helicobacter pylori\n Infection: A Pilot Study","volume":"12","author":"Hsu P. I.","year":"2025","journal-title":"Advances in Digestive Diseases"},{"key":"e_1_2_9_32_1","unstructured":"EUCAST Clinical Breakpoints \u201cClinical Breakpoints and Dosing of Antibiotics \u201d accessed January 10 2024 https:\/\/www.eucast.org\/clinical_breakpoints."},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2017.195"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12931"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.844915"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00140-17"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(25)02723-4"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.16679"}],"container-title":["Helicobacter"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hel.70131","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hel.70131","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hel.70131","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T04:08:00Z","timestamp":1788149280000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hel.70131"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":37,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1111\/hel.70131"],"URL":"https:\/\/doi.org\/10.1111\/hel.70131","archive":["Portico"],"relation":{},"ISSN":["1083-4389","1523-5378"],"issn-type":[{"value":"1083-4389","type":"print"},{"value":"1523-5378","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2026-02-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70131"}}