Real-world evidence on the efficacy and safety of vonoprazan-amoxicillin dual therapy for treatment in elderly patients.

Background: A dual therapy regimen containing amoxicillin is a common treatment option for the eradication of (). While substantial research supports the efficacy and safety of vonoprazan and amoxicillin (VA) dual therapy in the general population, there is still a lack of studies specifically focusing on its safety in elderly patients.

Aim: To evaluate efficacy and safety of VA dual therapy as first-line or rescue treatment for in elderly patients.

Methods: As a real-world retrospective study, data were collected from elderly patients aged 60 years and above who accepted VA dual therapy (vonoprazan 20 mg twice daily + amoxicillin 1000 mg thrice daily for 14 days) for eradication in the Department of Gastroenterology at Peking University First Hospital between June 2020 and January 2024. status was evaluated by C-urease breath test 6 weeks after treatment. All adverse events (AEs) during treatment were recorded.

Results: In total, 401 cases were screened. Twenty-one cases were excluded due to loss to follow-up, lack of re-examination, or unwillingness to take medication. The total of 380 included cases comprised 250 who received VA dual therapy as first-line treatment and 130 who received VA dual therapy as rescue treatment. was successfully eradicated in 239 cases (95.6%) in the first-line treatment group and 116 cases (89.2%) in the rescue treatment group. The overall incidence of AEs was 9.5% for both groups. Specifically, 9.2% of patients experienced an AE in the first-line treatment group and 10.0% in the rescue treatment group. Five patients discontinued treatment due to AE, with a discontinuation rate of 1.3%. No serious AE occurred.

Conclusion: The VA dual therapy regimen as a first-line treatment and a rescue therapy was effective and safe for elderly patients aged 60 and older.