7-day High-Dose Vonoprazan-amoxicillin Dual Therapy Versus 14-day Vonoprazan-amoxicillin Dual Therapy for H. Pylori

NCT07352098 — Not applicable, Not yet recruiting, 290 participants, Yueyue Li

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Efficacy and Safety of Short-Term, High-Dose Vonoprazan-Based Dual Therapy Versus Standard-Dose Vonoprazan-Based Dual Therapy for Helicobacter Pylori Eradication: A Multicenter, Open-Label, Randomized Controlled Trial

Registry	NCT07352098
Status	Not yet recruiting
Phase	Not applicable
Study type	Interventional; randomized, parallel, masking: none, treatment
Enrollment	290 (Estimated)
Sponsor	Yueyue Li (Other); collaborators: Qilu Hospital of Shandong University, Shandong University of Traditional Chinese Medicine, Zaozhuang Municipal Hospital, Qilu Hospital of Shandong University, Dezhou Branch, Yantai Zhifu Hospital, Kashi Prefecture Hospital of Traditional Chinese Medicine, Guanxian County People's Hospital
Conditions	Helicobacter
Interventions	7-day high-dose vonoprazan-amoxicillin dual therapy group, 14-day vonoprazan-amoxicillin dual therapy group (Drug)
Dates	start 2026-02-01 (estimated), primary completion 2028-02-01 (estimated), completion 2028-02-01 (estimated), first posted 2026-01-20, last updated 2026-01-20
Locations	1 site in China

-Summary

Helicobacter pylori infection is a prevalent global gastrointestinal condition linked to chronic gastritis, peptic ulcer disease, and gastric cancer. Potent and sustained acid suppression improves eradication efficacy. Vonoprazan, a potassium-competitive acid blocker, provides rapid and stable acid inhibition and has become an important component of dual therapy with amoxicillin. However, the optimal dosing strategy and treatment duration for vonoprazan-based dual therapy are not yet fully established.

This multicenter, open-label, randomized controlled trial compares the efficacy and safety of a short-term, high-dose vonoprazan-based dual therapy (20 mg three times daily for 7 days) with a standard-dose regimen (20 mg twice daily for 14 days), both combined with amoxicillin, for first-line H. pylori eradication. Adult participants with confirmed H. pylori infection will be randomized 1:1 to the two treatment groups. The primary outcome is the eradication rate of H. pylori at 6 weeks after completion of therapy. Secondary outcomes include safety assessments and medication adherence. This study will provide evidence on whether a higher dose and shorter treatment course can achieve similar eradication rates with acceptable safety and tolerability compared to the standard regimen.

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+Arms and interventions

Arm	Type	Interventions	Description
7-day high-dose vonoprazan-amoxicillin dual therapy group	Experimental	Drug: 7-day high-dose vonoprazan-amoxicillin dual therapy group
14-day vonoprazan-amoxicillin dual therapy group	Experimental	Drug: 14-day vonoprazan-amoxicillin dual therapy group

7-day high-dose vonoprazan-amoxicillin dual therapy group (Drug): Patients in the 7-day high-dose vonoprazan-amoxicillin dual therapy group received vonoprazan fumarate tablets 20 mg three times daily, administered 30 minutes before meals, and amoxicillin 1,000 mg three times daily, taken after meals. Both medications were administered orally for 7 consecutive days.
14-day vonoprazan-amoxicillin dual therapy group (Drug): Patients in the 14-day vonoprazan-amoxicillin dual therapy group received vonoprazan fumarate tablets 20 mg twice daily, administered 30 minutes before meals, and amoxicillin 1,000 mg three times daily, taken after meals. Both medications were administered orally for 14 consecutive days.

+Outcome measures

Primary outcomes

Eradication rate [6 weeks after treatment]

Secondary outcomes

incidence of adverse events [immediately after treatment]

+Eligibility

Sex: All, ages: 18 Years to 70 Years

Inclusion Criteria:

* Age 18-70 years, no gender restrictions;
* Patients with H. pylori infection confirmed by 13C/14C-urea breath test ;
* No prior history of H. pylori eradication therapy;

Exclusion Criteria:

* Patients allergic to study medications (vonoprazan fumarate, amoxicillin);
* Patients with active qastrointestinal bleeding,;
* Patients undergone or scheduled to undergo surgery within 1 month prior to randomization or during the study period that may affect gastric acid secretion (e.g., gastric surgery, vagotomy, or craniotomy);
* Patients underlying severe medical conditions deemed by the investigator to potentially confound study results or compromise subject safety, such as: hepatic impairment (ALT or AST > 1.5 times the upper limit of normal); renal impairment (Cr ≥ 2.0 mg/dL or eGFR < 50 mL/min/1.73 m²); immunosuppression; malignancy; severe central nervous system, cardiovascular, or respiratory disease;
* Patients with medication history of bismuth, antibiotics within 4 weeks, or proton pump inhibitors within 2 weeks;
* Patients with behaviors potentially increasing disease risk: history of chronic substance abuse or alcohol dependence within 12 months prior to screening;
* Patients planning pregnancy, currently pregnant, breastfeeding, or unwilling to use contraception during the trial period;
* Patients unable or unwilling to provide informed consent.

+Locations (1)

Facility	City	Country	Status
Kashi Prefecture Hospital of Traditional Chinese Medicine	Kashgar, Xinjiang	China

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