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We read with great interest the prospective study by Sue et al. evaluating a 7-day therapy against H. pylori using VPZ/ CAM/MNZ (VCM) in twenty patients with allergy to penicillin [1]. This survey showed that the effectiveness of VPZ-based regimen is much more than PPI-based therapy applied to those 29 Japanese patients (95% CI: 86.1–100%). At least in Japan, vonoprazan is bringing a novel era in the management of gastric acid-related diseases [2]. Although the study by Sue et al. was a novel prospective trial, there are some ethical and technical issues in light of population limitations which may influence the final conclusion by the authors.

Comment on “First-Line Helicobacter pylori Eradication with Vonoprazan, Clarithromycin, and Metronidazole in Patients Allergic to Penicillin”