Dual Therapy Effective for H pylori Eradication in T2D

TOPLINE:

A 14-day treatment regimen with vonoprazan plus amoxicillin is effective and safe for eradicating Helicobacter pylori (H pylori) infections in patients with type 2 diabetes (T2D), with superior eradication rates achieved in those avoiding smoking and achieving glycemic control.

METHODOLOGY:

• Developing a safe and effective H pylori eradication regimen for patients with diabetes is essential because they are more susceptible to such infections and have a greater risk for treatment failure than individuals without T2D.
• Researchers conducted a prospective, single-center trial in a hospital in China between April and December 2023 to study the safety and effectiveness of vonoprazan-amoxicillin dual therapy in patients with T2D diagnosed with H pylori infection, confirmed using the rapid urease test or 13C urea breath test.
• Along with standard medications to manage T2D, patients received vonoprazan (20 mg, twice daily, before meals) and amoxicillin (750 mg, thrice daily, after meals) dual therapy for 14 days.
• The primary outcome was the H pylori eradication rate; the secondary outcomes were rates of adverse events, patient compliance (intake of at least 80% of all prescribed medications defined as good compliance), factors associated with the eradication of H pylori, and the effect of its eradication on A1c levels.

TAKEAWAY:

• Among 75 patients enrolled (mean age, 61.91 years; 58.70% men; mean A1c level, 7.79%), the eradication rate of H pylori was 84.0%.
• Independent risk factors identified for the eradication failure of H pylori were smoking (adjusted odds ratio [aOR], 4.59; P = .026) and elevated A1c levels (aOR, 1.65; P = .044).
• Adverse events occurred in 13.3% of patients, with no reports of any severe adverse events; almost all patients (93.3%) showed good compliance with the dual therapy.
• A1c levels at 3 months posttreatment were significantly reduced in patients who achieved successful eradication of H pylori compared with the pre-eradication A1c levels (7.23 vs 7.70; P = .006); however, no significant differences were noted in patients who failed to achieve the eradication of H pylori.

IN PRACTICE:

“T2D patients should abstain from smoking and achieve optimal glycemic control to increase the eradication rate of H pylori,” the authors wrote.

SOURCE:

This study was led by Jie Zhang and Xin Cao, Departments of Gastroenterology and Endocrinology, Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou Medical Center, Changzhou, China. It was published online in Scientific Reports.

LIMITATIONS:

This study was limited by its single-center and single-arm design. Antibiotic susceptibility tests were not performed, so the impact of varying antibiotic resistance on the eradication rate of the 14-day vonoprazan-amoxicillin dual therapy could not be assessed. Confounding factors affecting the A1c levels, such as diet, medications, and exercise, were not analyzed.

DISCLOSURES:

This study was supported by the Top Talent of Changzhou “The 14th Five-Year Plan” High-Level Health Talents Training Project, Clinical Research Project of Changzhou Medical Center of Nanjing Medical University, and Science and Technology Project of Changzhou Health Commission. The authors declared no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.