{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T14:09:51Z","timestamp":1793196591478,"version":"4.5.0"},"reference-count":39,"publisher":"S. Karger AG","issue":"4","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Digestion"],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:p>Introduction: Vonoprazan, a novel potassium-competitive acid blocker, has a strong acid suppression effect and potent efficacy in acid-associated diseases, including Helicobacter pylori eradication. We performed a systematic review and meta-analysis to investigate the efficacy and safety of vonoprazan\/amoxicillin dual therapy for H. pylori eradication. Methods: We conducted a systematic literature search through PubMed, Web of Science, EMBASE, and the Cochrane Library up to June 2022, to identify randomized controlled trials and cohort studies comparing vonoprazan\/amoxicillin dual therapy and triple therapies for H. pylori eradication. Primary outcomes were cure rates and relative efficacy. Secondary outcomes included adverse events, dropout rate, and subgroup analysis. Results: Five studies with 1,852 patients were included in the analysis. The cure rates of vonoprazan\/amoxicillin dual therapy were 85.6% with 95% confidence interval (CI) of 79.7\u201391.5% and 88.5% (95% CI: 83.2\u201393.8%) in the intention-to-treat and per-protocol analyses. The efficacy of vonoprazan\/amoxicillin dual therapy was not inferior to that of triple therapy with pooled risk ratio (RR) of 1.03 (95% CI: 0.97\u20131.10) and 1.02 (95% CI: 0.98\u20131.08) in intention-to-treat and per-protocol analyses; while it was significantly superior to the omeprazole or lansoprazole-based triple therapy (RR = 1.15, 95% CI: 1.05\u20131.25, p = 0.001). For clarithromycin-resistant strains, vonoprazan\/amoxicillin dual therapy showed superiority to vonoprazan-based triple therapy (86.7% vs. 71.4%, RR = 1.20, 95% CI: 1.03\u20131.39, p = 0.02); however, vonoprazan\/amoxicillin dual therapy was significant inferior to vonoprazan-based triple therapy for clarithromycin-sensitive strains (83.0% vs. 92.8%, RR = 0.90, 95% CI: 0.85\u20130.95, p = 0.0002). The adverse effects of vonoprazan\/amoxicillin dual therapy were lower than those of triple therapy (21.2% vs. 26.5%, RR = 0.86, 95% CI: 0.73\u20131.01, p = 0.06), especially the incidence of diarrhea (p = 0.01). Conclusions: The efficacy of vonoprazan\/amoxicillin dual therapy is noninferior to vonoprazan-based triple therapy but superior to the omeprazole or lansoprazole-based triple therapy and has less side effects. Patients with clarithromycin-resistant strains are particularly expected to benefit from vonoprazan\/amoxicillin dual therapy. <\/jats:p>","DOI":"10.1159\/000529622","type":"journal-article","created":{"date-parts":[[2023,4,4]],"date-time":"2023-04-04T21:00:36Z","timestamp":1680642036000},"page":"249-261","source":"Crossref","is-referenced-by-count":35,"title":["Efficacy and Safety of Vonoprazan and Amoxicillin Dual Therapy for Helicobacter pylori Eradication: A Systematic Review and 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