Optimizing proton pump inhibitors in Helicobacter pylori treatment: Old and new tricks to improve effectiveness

Table 1 Main studies exploring very high dose vs standard proton pump inhibitors dose in Helicobacter pylori eradication regimens

Study	PPI comparison	Antibiotic regimen	Very high dose eradication rate (%)	Standard dose eradication rate (%)
De Francesco et al[16], 2016	Esomeprazole 20 mg vs 40 mg bid	14-d triple therapy (CLA+AMO)	59/72 (81.9)	54/73 (73.9)
Gisbert et al[23], 2005	Esomeprazole 20 mg vs 40 mg bid	7-d triple therapy (CLA+AMO)	117/150 (78)	111/150 (74)
Anagnostopoulos et al[24], 2004	Omeprazole 20 mg vs esomeprazole 40mg bid	7-d triple therapy (CLA+AMO)	50/52 (96.1)	37/52 (71.1)
Sheu et al[25], 2005	Omeprazole 20 mg vs esomeprazole 40 mg bid	7-d triple therapy (CLA+AMO)	86/100 (86)	79/100 (79)
Manes et al[26], 2005	Omeprazole 20 mg vs omeprazole 40 mg bid	7-d triple therapy (CLA+TNZ)	132/161 (82)	135/162 (83.3)
Choi et al[27], 2007	Omeprazole 20 mg vs esomeprazole 40 mg bid	7-d triple therapy (CLA+AMO)	104/148 (70.3)	290/428 (67.7)
Hu et al[28], 2017	Rabeprazole 10 mg vs 20 mg qid	14-d dual therapy (AMO)	71/87 (81.6)	68/87 (78.1)

All percentages are expressed as intention to treat. AMO: Amoxicillin; CLA: Clarithromycin; TNZ: Tinidazole; PPI: Proton pump inhibitors.

Table 2 Randomized controlled trials comparing vonoprazan vs proton pump inhibitors for Helicobacter pylori eradication regimens

Study	Protocol in vonoprazan group	Protocol in PPI group	Eradication rate in vonoprazan group	Eradication rate in PPI group
Murakami et al[53], 2016	Vonoprazan 20 mg bid	LAN 30 mg AMO 750 mg bid	299/329 (90.9%)	241/321 (75.1%)
	AMO 750 mg bid	CLA 400 mg bid
	CLA 400 mg bid
Maruyama et al[54], 2017	Vonoprazan 20 mg bid	LAN 30 mg or RAB 20 mg bid	69/72 (95.8%)	48/69 (69.6%)
	AMO 750 mg bid	AMO 750 mg bid
	CLA 400 mg bid	CLA 400 mg bid
Sue et al[55], 2018	Vonoprazan 20 mg bid	LAN 30 mg or RAB 10 mg or ESO 20 mg bid	48/55 (87.3%)	39/51 (76.5%)
	AMO 750 mg bid	AMO 750 mg bid
	CLA 400 mg bid	CLA 400 mg bid

All percentages are expressed as intention to treat. AMO: Amoxicillin; CLA: Clarithromycin; ESO: Esomeprazole; LAN: Lansoprazole; RAB: Rabeprazole; PPI: Proton pump inhibitors.