Du Ren-Chun, Ouyang Yao-Bin, Lu Nong-Hua, Hu Yi
Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, Nanchang, China.
Department of Oncology, Mayo Clinic, Rochester, Minnesota, USA.
Helicobacter. 2023 Oct;28(5):e13012. doi: 10.1111/hel.13012. Epub 2023 Jul 29.
Vonoprazan is an emerging option for the treatment of Helicobacter pylori infection. We aimed to assess the research trends and hotspots of vonoprazan-based therapy for H. pylori eradication through bibliometric analysis.
Vonoprazan-based studies for eradicating H. pylori published from 2015 to 2023 were extracted from the Web of Science using a combination of the search terms "H. pylori" and "vonoprazan." Each study was weighted according to the number of included patients.
A total of 65 studies were included. Japan was the most productive and cooperative country, accounting for 69.2% of publications. Vonoprazan in combination with amoxicillin and clarithromycin (41.8%) was most used for eradicating H. pylori, followed by vonoprazan in combination with amoxicillin (20.4%) and vonoprazan in combination with amoxicillin and metronidazole (19.4%). The eradication rates for first-line vonoprazan-based therapies by intention to treat were: dual therapy (82.9%, 95% CI: 77.7%-88.0%), triple (83.3%, 95% CI: 79.7%-86.8%) and quadruple therapy (91.5%, 95% CI: 85.5%-97.4%), and per protocol: dual therapy (86.1%, 95% CI: 81.5%-90.7%), triple (89.3%, 95% CI: 87.9%-90.6%) and quadruple therapy (94.0%, 95% CI: 88.6%-99.4%). Vonoprazan was superior to proton pump inhibitors in triple therapy regarding empirical therapy (RR = 1.18, 95% CI, 1.14-1.22, p < 0.01) and clarithromycin-resistant group (RR = 1.71, 95% CI, 1.33-2.20, p < 0.01), but there is no significant difference between triple therapy and dual therapy (RR = 1.02, 95% CI, 0.98-1.07, p = 0.33).
Vonoprazan has been widely used for H. pylori eradication. Further studies are needed to optimize the best duration and dosage of vonoprazan-based regimens in different regions.
沃克帕唑是治疗幽门螺杆菌感染的一种新选择。我们旨在通过文献计量分析评估基于沃克帕唑的幽门螺杆菌根除疗法的研究趋势和热点。
使用 “幽门螺杆菌” 和 “沃克帕唑” 的搜索词组合,从Web of Science中提取2015年至2023年发表的基于沃克帕唑根除幽门螺杆菌的研究。每项研究根据纳入患者数量进行加权。
共纳入65项研究。日本是产出最多且合作最多的国家,占出版物的69.2%。沃克帕唑联合阿莫西林和克拉霉素(41.8%)最常用于根除幽门螺杆菌,其次是沃克帕唑联合阿莫西林(20.4%)和沃克帕唑联合阿莫西林和甲硝唑(19.4%)。基于沃克帕唑的一线治疗按意向性分析的根除率为:双联疗法(82.9%,95%CI:77.7%-88.0%)、三联疗法(83.3%,95%CI:79.7%-86.8%)和四联疗法(91.5%,95%CI:85.5%-97.4%),按符合方案分析为:双联疗法(86.1%,95%CI:81.5%-90.7%)、三联疗法(89.3%,95%CI:87.9%-90.6%)和四联疗法(94.0%,95%CI:88.6%-99.4%)。在经验性治疗(RR = 1.18,95%CI,1.14-1.22,p < 0.01)和克拉霉素耐药组(RR = 1.71,95%CI,1.33-2.20,p < 0.01)方面,沃克帕唑在三联疗法中优于质子泵抑制剂,但三联疗法和双联疗法之间无显著差异(RR = 1.02,95%CI,0.98-1.07,p = 0.33)。
沃克帕唑已广泛用于幽门螺杆菌根除。需要进一步研究以优化不同地区基于沃克帕唑方案的最佳疗程和剂量。