Ten-day tegoprazan-based concomitant therapy as a first-line treatment for Helicobacter pylori eradication

• Published in: The Korean journal of internal medicine Vol. 38; no. 4; pp. 493 - 503
• Main Authors: Yong Hwan Kwon, Seong Woo Jeon, Su Youn Nam, Dong Wook Lee, Ji Hey Park, Hui Jin Bae
• Format: Journal Article
• Language: Korean
• Published: 대한내과학회 2023
• Subjects: Antibiotic resistance; Clarithromycin; Helicobacter pylori; Metronidazole; Tegoprazan
• ISSN: 1226-3303; 2005-6648

Background/Aims: Tegoprazan, a novel potassium-competitive acid blocker, has shown rapid action and gastric acid inhibition. In this study, we evaluated the efficacy of a tegoprazan-based, nonbismuth-containing quadruple (concomitant) therapy for the primary eradication of Helicobacter pylori.
Methods: We conducted a prospective, single-arm, single-center, primitive study to verify the efficacy of a 10-day tegoprazan- based (50-mg dose) concomitant therapy, including amoxicillin (1,000-mg dose), clarithromycin (CLA; 500-mg dose), and metronidazole (MET; 500-mg dose) twice daily as a first-line treatment for H. pylori eradication.
Results: We tested consecutive cultures for antibiotic susceptibility and minimum inhibitory concentrations. We enrolled 84 participants; 79 (94.0%) completed first-line therapy. The overall intention-to-treat and per-protocol eradication rates were 90.5% (95% confidence interval [CI], 82.1-95.8) and 96.2% (95% CI, 83.4-97.6), respectively. Of the 73 participants evaluated for antibiotic resistance, 19 (26.0%), 32 (42.5%), and 8 (11.0%) exhibited CLA, MET, and CLA and MET dual resistance, respectively. Of these, 39 participants (66.1%) exhibited successful eradication after the therapeutic regimen despite antibiotic resistance.
Conclusions: The 10-day tegoprazan-based concomitant therapy may be an effective first-line treatment for eradicating H. pylori.