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Efficacy and safety of a new rifabutin‐based triple therapy with vonoprazan for refractory Helicobacter pylori infection: A prospective single‐arm study
Author(s) -
Hirata Yoshihiro,
Yamada Atsuo,
Niikura Ryota,
Shichijo Satoki,
Hayakawa Yoku,
Koike Kazuhiko
Publication year - 2020
Publication title -
helicobacter
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 79
eISSN - 1523-5378
pISSN - 1083-4389
DOI - 10.1111/hel.12719
Subject(s) - rifabutin , medicine , helicobacter pylori , adverse effect , metronidazole , amoxicillin , clarithromycin , gastroenterology , urea breath test , antibiotics , microbiology and biotechnology , helicobacter pylori infection , biology
Background A small proportion of Helicobacter pylori ‐infected individuals in Japan suffer failure of eradication therapy with third‐line regimens containing the potent acid suppressor, vonoprazan, and a quinolone. Objectives This prospective study evaluated the efficacy and safety of rifabutin‐based triple therapy with vonoprazan for refractory H pylori infection. Methods Patients who failed H pylori eradication by clarithromycin‐based first‐line, metronidazole‐based second‐line, and sitafloxacin‐based third‐line therapies were recruited. After obtaining informed consent, patients received eradication therapy with vonoprazan (20 mg), amoxicillin (750 mg), and rifabutin (150 mg) twice daily for 10 days. Eradication was confirmed by a negative H pylori stool antigen or urea breath test at least 8 weeks after the end of therapy. Results Nineteen patients were included in the study. All of the patients completed the course of medication. Eradication of H pylori was confirmed in all of the patients (19/19; 100%, 95% confidence interval; 83‐100%). The most common adverse event was soft stool/diarrhea (4/19, 21%). No severe adverse event was observed. Conclusions Ten‐day rifabutin with amoxicillin and vonoprazan triple therapy appears to be effective and safe for refractory H pylori infections. However, considering the recent publications showing high eradication rates with vonoprazan amoxicillin dual therapy, confirmation will require future studies comparing our new therapy with vonoprazan‐amoxicillin dual with similar doses and duration and with vonoprazan‐rifabutin dual therapy.