Vonoprazan and proton pump inhibitors: Which is superior for eradication?

is a worldwide health problem; therefore, eradicating this bacterium is important for the health and economic status of the whole world. There are a variety of anti-secretory and antibiotic combinations for this purpose; however, antibiotic resistance is a major barrier to achieving an appropriate eradication rate (> 90%). Blockage of gastric acid is the main supportive factor of the antibiotic effect on bacteria. Therefore, anti-secretory therapy with high efficacy and safety profiles should be used in eradication regimens. Vonoprazan (VPZ), a member of the potassium competitive acid blockers, is a novel agent with a potent anti-secretory effect. The present study aimed to summarize comparative and safety studies of VPZ and proton pump inhibitors (PPIs), especially the efficacy on eradication. VPZ was reported to have a higher efficacy and safety profile in most studies that compared VPZ-based and PPI-based regimens for eradication therapy. Despite its greater cost, the effectiveness of VPZ emerges as a viable and cost-effective alternative to PPI on gastric acid-related pathologies.