Voquezna (vonoprazan) / Takeda, Otsuka, Phathom Pharma - LARVOL DELTA

Vonoprazan Evaluation Compared to Standard Triple Therapy in Helicobacter Pylori eRadication (clinicaltrials.gov) - P4 | N=484 | Recruiting | Sponsor: Asian Institute of Gastroenterology, India | Active, not recruiting ➔ Recruiting

Enrollment open • Infectious Disease

A Randomized, Three-Arm Study Comparing Vonaprazan 10 mg, Vonaprazan 20 mg, and Esomeprazole 40 mg for the Healing of LA Grade B or Higher Reflux Esophagitis at 8 Weeks (clinicaltrials.gov) - P=N/A | N=414 | Recruiting | Sponsor: Asian Institute of Gastroenterology, India | Not yet recruiting ➔ Recruiting

Enrollment open • Gastroesophageal Reflux Disease • Gastrointestinal Disorder

Efficacy of Three Amoxicillin Doses in Vonoprazan Dual Therapy for Helicobacter pylori Eradication: A Randomized Noninferiority Trial. (PubMed, Helicobacter) - P4 | "A 14-day VA regimen requires ≥ 2 g/d amoxicillin to maintain noninferior eradication efficacy versus 3 g/d, supporting dose reduction without compromising effectiveness."

Clinical • Head-to-Head • Journal • Infectious Disease

Vonoprazan-minocycline dual therapy for primary eradication of Helicobacter pylori infection:a prospective, multicenter, randomized controlled trial (ChiCTR) - P4 | N=580 | Not yet recruiting | Sponsor: Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology; Tongji Hospital, Tongji Medical College, Huazhong University o

New P4 trial • Infectious Disease

A multicenter randomized controlled study of a first-line eradication of Helicobacter pylori with a combination of vonoprazan and minocycline (ChiCTR) - P=N/A | N=436 | Not yet recruiting | Sponsor: The First Affiliated Hospital of Soochow University; The First Affiliated Hospital of Soochow University

New trial • Infectious Disease

Mechanisms of Gut Microbiota in Improving Metabolic Syndrome-Related Parameters Following Helicobacter pylori Eradication. (ChiCTR) - P=N/A | N=140 | Recruiting | Sponsor: Nanjing First Hospital; Nanjing First Hospital

New trial • Infectious Disease • Metabolic Disorders

Efficacy and safety of vonoprazan and tetracycline dual therapy for Helicobacter pylori eradication: a prospective study (ChiCTR) - P4 | N=100 | Recruiting | Sponsor: The First Affiliated Hospital of Nanchang University; The First Affiliated Hospital of Nanchang University

New P4 trial • Infectious Disease

Evaluation of the therapeutic effect of dual dose combination therapy (P-CAB+Amoxicillin) in the rescue treatment of Helicobacter pylori (ChiCTR) - P=N/A | N=120 | Recruiting | Sponsor: Northern Jiangsu People's Hospital; Northern Jiangsu People's Hospital

New trial • Infectious Disease

Italian guidelines for the diagnosis and management of gastro-esophageal reflux disease: Joint consensus from the Italian Societies of: Gastroenterology and Endoscopy (SIGE), Neurogastroenterology and Motility (SINGEM), Hospital Gastroenterologists and Endoscopists (AIGO), Digestive Endoscopy (SIED), and General Medicine (SIMG). (PubMed, Dig Liver Dis) - "Moreover, the consensus voted for the use of potassium competitive acid blockers (P-CABs), antacids, alginate-containing formulations, neuromodulators in treating visceral hypersensitivity, complementary and alternative medicine and anti-reflux surgery in patients with refractory GERD. Finally, the consensus voted against surgical anti-reflux therapy in patients with extra-esophageal symptoms of GERD, who do not respond to PPI therapy and against the use of ensoscopic procedures [i.e., Medigus ultrasonic surgical endostapler (MUSE), radiofrequency energy application (Stretta), anti-reflux mucosectomy (ARMS)] outside clinical trials."

Clinical guideline • Journal • Barrett Esophagus • Eosinophilic Esophagitis • Gastroenterology • Gastroesophageal Reflux Disease • Gastrointestinal Disorder • Immunology

Comparative Efficacy of Potassium-Competitive Acid Blocker-Based Triple Therapy with Tegoprazan versus Vonoprazan for Helicobacter pylori Eradication: A Randomized, Double-Blind, Active-Controlled Pilot Study. (PubMed, Gut Liver) - P3 | "Participants were randomized 1:1:1 to receive tegoprazan 50 mg (TAC 1), tegoprazan 100 mg (TAC 2), or vonoprazan 20 mg (VAC) with amoxicillin 1,000 mg plus clarithromycin 500 mg twice daily for 10 days. After 10 days, tegoprazan 100 mg showed eradication rates comparable to those of vonoprazan 20 mg, while 50 mg may be insufficient. These findings support future research to optimize tegoprazan dosing in clinical practice (ClinicalTrials.gov; NCT04128917)."

Clinical • Journal • Infectious Disease

Comparison of Vonoprazan Triple Therapy, Bismuth Quadruple Therapy, and Amoxicillin Therapy for Helicobacter pylori Infection: A Systematic Review. (PubMed, Cureus) - "However, high doses of amoxicillin emerge as the safest and most effective treatment, especially where clarithromycin resistance is prevalent. Personalized treatment, taking into account patient preferences, tolerability, and concerns about resistance, will likely continue to offer the best chance for successful eradication. Ultimately, the goal is to select the most suitable therapy for each patient, ensuring both the effectiveness and comfort of the treatment."

Journal • Review • Critical care • Infectious Disease

Clinical Effectiveness of Penicillin-Free Therapies in First-Line and Rescue Treatments for Helicobacter pylori: A Systematic Review. (PubMed, Antibiotics (Basel)) - "Background and Aims: Amoxicillin is one of the most effective antibiotics for treating Helicobacter pylori infections and is widely used in first-line treatment regimens...Key findings demonstrated high eradication rates with bismuth-based quadruple therapies (88-97%), doxycycline-based regimens (86%), and quinolone-based therapies (75-100%), with Sitafloxacin exceeding 90% efficacy. Minocycline-based regimens also showed promising outcomes, with eradication rates between 80% and 85%...Vonoprazan-based therapy is an effective regimen. Combined with clarithromycin and metronidazole, vonoprazan enhances eradication rates and demonstrates effectiveness, including in clarithromycin-resistant strains."

Journal • Review • Allergy • Immunology • Infectious Disease

Advances in Gastroesophageal Reflux Disease Management: Exploring the Role of Potassium-Competitive Acid Blockers and Novel Therapies. (PubMed, Pharmaceuticals (Basel)) - "Emerging treatment options include potassium-competitive acid blockers (PCABs) like vonoprazan, which offer more potent and sustained inhibition of gastric acid secretion compared to traditional PPIs. Additionally, prokinetic agents such as itopride have gained attention due to their potential to improve GERD symptoms by enhancing gastrointestinal motility and accelerating gastric emptying. This article reviews the mechanisms of action, clinical efficacy, and potential of these novel therapeutic approaches in improving patient outcomes in GERD management. With the growing prevalence of PPI resistance and side effects, a personalized, multifaceted approach to treatment is becoming increasingly necessary to optimize care for patients with GERD."

Journal • Review • Gastroenterology • Gastroesophageal Reflux Disease • Gastrointestinal Disorder • Pain

Vonoprazan or Proton Pump Inhibitor for Gastric Endoscopic Submucosal Dissection in Patients Taking Antithrombotic Agents. (PubMed, J Gastroenterol Hepatol) - "The present study did not demonstrate the superiority of VPZ over PPIs in preventing delayed bleeding after gastric ESD in patients taking antithrombotic agents."

Journal • Gastric Cancer • Oncology • Solid Tumor

Acute Generalized Exanthematous Pustulosis With Negative Patch Test and Drug-Induced Lymphocyte Stimulation Test (DLST) Results: A Case Report. (PubMed, Cureus) - "It is most often drug-induced, commonly triggered by antibiotics, anticancer agents, or hydroxychloroquine...All three drugs were discontinued, and the patient responded well to topical corticosteroids and oral prednisolone...However, based on previous reports of severe vonoprazan-induced drug eruptions and the lack of evidence linking paclitaxel or oral iron to AGEP, vonoprazan was considered the most likely culprit...This case highlights the limitations of patch testing and DLST in AGEP diagnosis and emphasizes the importance of clinical context and therapeutic priorities in evaluating drug causality. Further studies are needed to standardize AGEP testing protocols and improve diagnostic accuracy."

Journal • Dermatology • Immunology • Oncology

Blockade of ATP12A Activity in Distal Airway Basal Cells From IPF Lungs Attenuates Aberrant Cell Differentiation and Mitigates Profibrotic Functions (ATS 2025) - "In murine models, overexpression of ATP12A exacerbates bleomycin-induced lung fibrosis, which is blocked by vonoprazan (VON), a potassium-competitive proton pump inhibitor. Overexpression of ATP12A in IPF-SABCs may contribute to the development of IPF by promoting mucociliary dysfunction in the small airways. Targeting ATP12A in IPF-SABCs presents a promising therapeutic strategy for treating IPF."

Fibrosis • Idiopathic Pulmonary Fibrosis • Immunology • KRT5 • MUC5AC • MUC5B • TP63

Restoration of intestinal barrier function by fexuprazan, a potassium-competitive acid blocker, in Caco-2 cells and its higher gastrointestinal distribution in rats. (PubMed, Biomed Pharmacother) - "Treatment with fexuprazan, esomeprazole, tegoprazan, and vonoprazan significantly increased TEER values in a 3 % DSS-induced ulcerative colitis Caco-2 cells in a concentration-dependent manner. Fexuprazan showed a particularly high distribution in the liver and gastrointestinal tract in rats following oral administration of 2 mg/kg fexuprazan, which appears to be a positive characteristic of fexuprazan's effect on ulcerative colitis and gastric acid-related diseases although in vivo therapeutic efficacy of fexuprazan for ulcerative colitis requires further validation in both animal and human. In conclusion, fexuprazan can potentially restore intestinal barrier function by increasing the expression of tight junction genes and by strengthening the cell membrane integrity in DSS-induced colitis model."

Journal • Preclinical • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammatory Bowel Disease • Ulcerative Colitis • CLDN1 • MUC1 • OCLN • TJP1

THE SYNERGISTIC EFFECT OF COLLOIDAL BISMUTH CITRATE WITH CLARITHROMYCIN WAS ENHANCED WITH THE INCREASE OF THE MINIMAL INHIBITORY CONCENTRATION OF CLARITHROMYCIN IN CLINICAL CHILDREN (ESPGHAN 2025) - "Vonoprazan are still not allowed in children. Four clinical samples and 1 standard strain resistant to MET were also measured, and the results showed that there was no clear synergistic effect between CBS and MET. Conclusions CBS may have an inhibitory effect on the high degree of clarithromycin resistance of H. pylori ."

Clinical • Gastroenterology • Infectious Disease

Vonoprazan: A Review in Erosive Esophagitis and Non-Erosive Gastro-Esophageal Reflux Disease. (PubMed, Drugs) - "In pivotal phase III trials, vonoprazan was non-inferior to the PPI lansoprazole in healing and superior to lansoprazole in maintenance of healing of erosive esophagitis, and was superior to placebo for treating heartburn in US patients with non-erosive GERD. Vonoprazan was generally well tolerated; the most common adverse events included abdominal pain, constipation, diarrhea, nausea, and dyspepsia. Vonoprazan is, therefore, a valuable addition to the therapies available for adults with erosive esophagitis and non-erosive GERD."

Journal • Review • Constipation • Dyspepsia • Gastroenterology • Gastroesophageal Reflux Disease • Gastrointestinal Disorder • Pain

Clinical evaluation of personalized Helicobacter pylori treatment guided by PCR detection from fecal samples: a real-world study. (PubMed, Front Cell Infect Microbiol) - "Fecal samples were analyzed using fluorescence PCR for the 23S rRNA and gyrA genes, indicating clarithromycin and levofloxacin resistance. The eradication rates for HDDT, based on either vonoprazan or esomeprazole, were 96.8% (61/63, 95% CI: 89.0%-99.6%) and 85.7% (12/14, 95% CI: 57.2%-98.2%), respectively, without a significant difference (P=0.304). PCR detection from fecal samples targeting the resistance genes of H. pylori is effective in guiding personalized treatments, highlighting its clinical utility and potential for broader application."

Journal • Real-world evidence • Infectious Disease

The Effects of High-dose Dual Therapy With Probiotics on Gut Microbiota for Helicobacter Pylori Rescue Treatment (clinicaltrials.gov) - P=N/A | N=72 | Completed | Sponsor: Zhongshan Hospital (Xiamen), Fudan University | Recruiting ➔ Completed

Trial completion • Infectious Disease • Metabolic Disorders

The Need of Revisiting to an Outpatient Clinic After the Prescription of Vonoprazan or Esomeprazole (clinicaltrials.gov) - P=N/A | N=300 | Completed | Sponsor: Showa Inan General Hospital | Recruiting ➔ Completed

Trial completion • Gastroenterology • Gastroesophageal Reflux Disease • Gastrointestinal Disorder

Evaluating the cost-effectiveness of replacing lansoprazole with vonoprazan for treating erosive oesophagitis. (PubMed, BMJ Open Gastroenterol) - "Vonoprazan is potentially cost-effective for the initial healing of severe oesophagitis, after endoscopic diagnosis. Further trials and economic evaluations are necessary for the symptom-based prescription of vonoprazan and to determine the optimal dosage, frequency and duration."

HEOR • Journal • Gastroenterology • Gastroesophageal Reflux Disease • Gastrointestinal Disorder

Vonoprazan-based therapy versus standard regimen for Helicobacter pylori infection management in Egypt: an open-label randomized controlled trial. (PubMed, Sci Rep) - P4 | "The study evaluates the efficacy, safety, and compliance of vonoprazan dual and triple therapy (VDT and VTT) both consisting of vonoprazan 20 mg twice daily and amoxicillin/clavulanate 875 mg/125 three times daily plus clarithromycin 500 mg twice daily added in VTT versus standard triple therapy (STT), in which vonoprazan 20 mg in VTT is replaced by PPI standard or double dose all for 14 days, along with investigating factors influencing compliance, treatment response, and symptoms severity. Gender, frequency of COVID-19 vaccination, height, and BMI were the only factors assessed influencing infection symptoms severity. ClinicalTrial.gov ID identifier: NCT05614934, first posted date (07/11/2022)."

Journal • Infectious Disease • Novel Coronavirus Disease

Comparison of Efficacy on First-Line Helicobacter Pylori Eradication Between Potassium-Competitive Acid Blocker (P-CAB)-Based Therapies Versus Proton-Pump Inhibitor (PPI)-Based Therapies: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. (PubMed, J Clin Gastroenterol) - "Vonoprazan-based triple therapy has a higher eradication rate than PPI-based triple therapies, as well as other P-CABs based regimens. It remains unclear whether VAC7 is superior over vonoprazan-based dual therapy (VA7). Overall, VAC7 should be recommended for clinical and public health interventions, with VA7 as a possible alternative considering the local antimicrobial resistance profiles."

Journal • Retrospective data • Gastric Cancer • Infectious Disease • Oncology • Solid Tumor