Effect of Vonoprazan, a Potassium-Competitive Acid Blocker, on the 13C-Urea Breath Test in Helicobacter pylori-Positive Patients

• Published in: Digestive diseases and sciences Vol. 62; no. 3; pp. 739 - 745
• Main Authors: Takimoto, Mayu, Tomita, Toshihiko, Yamasaki, Takahisa, Fukui, Shota, Taki, Masato, Okugawa, Takuya, Kondo, Takashi, Kono, Tomoaki, Tozawa, Katsuyuki, Arai, Eitatsu, Ohda, Yoshio, Oshima, Tadayuki, Fukui, Hirokazu, Watari, Jiro, Miwa, Hiroto
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-03-2017; Springer Nature B.V
• Subjects: Biochemistry; Breath tests; Gastroenterology; Hepatology; Medicine; Medicine & Public Health; Oncology; Original Article; Potassium; Transplant Surgery; Vonoprazan; Urea breath test
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-016-4439-0

Background and Aim
Vonoprazan (VPZ) is a new oral potassium-competitive acid blocker that has recently become available. The aim of this study was to investigate the effects of VPZ on the urease activity of
H. pylori
as measured by the
13
C-urea breath test (
13
C-UBT).
Patients and Methods
A total of 60 patients (26 men, 34 women; mean age 53.2 ± 13.6 years) who were diagnosed as
H. pylori
-positive were recruited. The patients were randomly allocated to three treatment groups: lansoprazole (LPZ) 30 mg (
n
 = 20), VPZ 20 mg (
n
 = 20) once daily for 3 weeks, or the control group (
n
 = 20). The
13
C-UBT was carried out at baseline and after 3 weeks of treatment, and the baseline and after treatment results then compared. Δ
13
C‰ ≥ 2.5‰ was considered
H. pylori
-positive.
Results
Four patients failed to complete the medication and were omitted from the analysis; data from the LPZ group (
n
 = 18), VPZ group (
n
 = 18), and control group (
n
 = 20) were analyzed. The control group showed no significant change in
13
C-UBT data between baseline and the completion of 3-week treatment (baseline: 26.6 ± 23.0‰, completion: 21.1 ± 13.1‰). The
13
C-UBT data at week 3 were significantly decreased in both the VPZ group (baseline: 32.8 ± 22.7‰, completion: 7.6 ± 9.2‰,
p
 = 0.0002) and the LPZ group (baseline: 41.8 ± 33.4‰; completion: 9.6 ± 8.8‰,
p
 = 0.0006) compared to baseline.
Conclusions
VPZ treatment reduced the value of UBT, warning that UBT for patients with VPZ treatment should be evaluated carefully.