Systematic review with meta‐analysis: the efficacy of vonoprazan‐based triple therapy on Helicobacter pylori eradication

Abstract Background In order to increase eradication rates, vonoprazan, a novel potassium‐competitive acid blocker, has been used in Helicobacter pylori eradication therapy. Aim To summarise the results of the efficacy of vonoprazan‐based triple therapy, helping clinicians to better understand the benefit of vonoprazan in the treatment of H. pylori infection. Methods We conducted a systematic literature search on MEDLINE , EMBASE , and the Cochrane Library using the primary keywords “vonoprazan,” “takecab”, “ TAK ‐438,” “potassium,” “competitive,” “potassium‐competitive,” “ Helicobacter ,” and “ pylori .” Studies were included if they evaluated the eradication rate between the vonoprazan‐based and proton pump inhibitor ( PPI )‐based triple therapies. Results Ten studies and 10 644 patients were evaluated. The crude H. pylori eradication rate determined by intention‐to‐treat analysis was 87.9% and 72.8% in the vonoprazan‐based triple therapy and PPI ‐based triple therapy respectively. The eradication rate of the vonoprazan‐based triple therapy was superior to that of the PPI ‐based triple therapy (pooled risk ratio [ RR ] [95% confidence interval ( CI )]=1.19 [1.15‐1.24]) In addition, there was no significant difference in dropout rate due to adverse event between the regimens (pooled RR of the vonoprazan‐based triple therapy [95% CI ]=0.69 [0.23‐2.03]). The incidence of any adverse events also did not differ between the regimens (pooled RR [95% CI ]=1.02 [0.78‐1.34]). Conclusions The vonoprazan‐based triple therapy showed superior efficacy in terms of H. pylori eradication as compared to the PPI ‐based triple therapy. In addition, the vonoprazan‐based triple therapy showed comparable tolerability and incidence of adverse events.