Successful eradication of Helicobacter pylori infection with vonoprazan-based triple therapy after failure of PPI-based triple therapy

In Japan, first- and second-line regimens for Helicobacter pylori (H. pylori) eradication consist of twice daily dosing (b.d.) with a proton pump inhibitor (PPI), such as amoxicillin (750mg), and clarithromycin (200/400mg) or metronidazole (250mg) for 7 days [1]. However, the rate of eradication has been gradually decreasing due to increased prevalence of clarithromycin-resistant H. pylori strains [1,2], thus third-line treatment with sitafloxacin is increasingly used with moderate success [3]. Recently, vonoprazan fumarate, a first-in-class potassium-competitive acid blocker (PCAB) with rapid, potent, and prolonged gastric acid suppression, became available for clinical use in Japan [4].

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