Ten‐day versus 14‐day vonoprazan‐amoxicillin high‐dose dual therapy for Helicobacter pylori eradication in China: A multicenter, open‐label, randomized study

Abstract Background and Aim Only a few studies have investigated the efficacy and safety of different durations of vonoprazan and amoxicillin (VA) high‐dose dual therapy for the eradication of Helicobacter pylori . We aimed to compare the efficacy and safety of 10 days versus 14 days of VA high‐dose dual therapy for H. pylori eradication. Methods This study was conducted in 14 centers in China. A total of 250 patients infected with H. pylori were randomly assigned to Group VA‐10 or VA‐14. Both groups received the VA dual therapy (vonoprazan 20 mg twice daily + amoxicillin 1000 mg three times daily). The primary endpoint was the H. pylori eradication rate. Secondary endpoints included adverse events and patient compliance. Results Group VA‐10 achieved eradication rates of 89.60%, 91.06%, and 91.67% as determined by the intention‐to‐treat (ITT), modified intention‐to‐treat (MITT), and per‐protocol (PP) analysis, respectively. The eradication rates were similar to those in Group VA‐14: 91.20%, 93.44%, and 93.39%. The difference and 90% confidence interval boundary −1.60% (−7.73% to 4.53%) in the ITT analysis, −2.39% (−8.00% to 3.23%) in the MITT analysis, and −1.72% (−7.29% to 3.85%) in the PP analysis were greater than the predefined noninferiority margin of −10%, establishing a noninferiority of Group VA‐10 versus Group VA‐14 (noninferiority P = 0.001 in ITT analysis, P < 0.001 in MITT analysis, and P < 0.001 in PP analysis, respectively). No significant differences were observed in adverse events between the two groups. Conclusions Ten‐day VA dual therapy achieves comparable efficacy and safety to the 14‐day regimen in Chinese population, providing patients with greater convenience and economic benefits.