第13巻 2017年2月　第1号

■臨床医のために

H. pylori除菌療法におけるボノプラザンとエソメプラゾールの比較検討
的場　秀亮¹, 吉田　寛¹, 鈴木　剛², 瀬田　真祐³, 高田　英志¹, 上田　純志¹, 丸山　弘¹, 横山　正¹, 牧野　浩司¹, 内田　英二^4
1日本医科大学多摩永山病院外科
²東都医療大学研究センター
³大坪会東和病院消化器科
⁴日本医科大学消化器外科

Comparison of Vonoprazan and Esomeprazole for Eradication of H. pylori Infection
Hideaki Matoba¹, Hiroshi Yoshida¹, Tsuyoshi Suzuki², Shinsuke Seta³, Hideyuki Takata¹, Jyunji Ueda¹, Hiroshi Maruyama¹, Tadashi Yokoyama¹, Hiroshi Makino¹ and Eiji Uchida^4
1)Department of Surgery, Nippon Medical School Tama Nagayama Hospital
²⁾Research Center, Tohto College of Health Sciences
³⁾Department of Gastroenterology, Towa Hospital
⁴⁾Department of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical School

The Helicobacter pylori (H. pylori) eradication rate has decreased slightly because of the increasing number of clarithromycin-resistant bacteria. However, vonoprazan-based triple therapy (vonoprazan 40 mg/day+amoxicillin 1,500 mg/day+clarithromycin 800 mg/day) retains the potential to eradicate H. pylori better than other proton pump inhibitor (PPI)-based triple therapies. Vonoprazan is a potassium-competitive acid blocker that differs from PPIs in its mechanism of action. We compared vonoprazan-based triple therapy and esomeprazole-based triple therapy (esomeprazole 40 mg/day+amoxicillin 1,500 mg/day+clarithromycin 800 mg/day) in terms of the H. pylori eradication rate. Vonoprazan-based triple therapy was used to treat patients with a history of H. pylori-infected gastritis and gastric or duodenal ulcers caused by H. pylori during the period April 2015 to April 2016, and the eradication rates were compared with those obtained in similar patients treated with esomeprazole-based triple therapy between August 2014 and March 2015. The first-line H. pylori eradication rate of vonoprazan-based triple therapy was 92%, and the second-line eradication rate was 100%. The corresponding figures for esomeprazole-based triple therapy were 84.8% and 60%. Subgroup analyses of the first-line H. pylori eradication rate showed almost the same trends. There was no statistically significant difference between the H. pylori eradication rate of vonoprazan-based triple therapy and the eradication rate of esomeprazole-based triple therapy.

日医大医会誌 2017; 13(1), 38-41

Key words
vonoprazan, esomeprazole, H. pylori, eradication therapy, eradication rate

Correspondence to
Hideaki Matoba, Department of Surgery, Nippon Medical School Tama Nagayama Hospital, 1-7-1 Nagayama, Tama Tokyo 206-8512, Japan
E-mail：hideaki.pb@gmail.com

受付：2016年10月27日　受理：2017年1月5日