Comparative Analysis of Vonoprazan- and Dexlansoprazole-Based Therapies for Helicobacter pylori Eradication: A Single-Center Retrospective Observational Study.
- 1Gastroenterology, VGM Hospital, Coimbatore, IND.
Abstract
Background and aim Vonoprazan, a potassium-competitive acid blocker (PCAB), has emerged as an alternative to proton pump inhibitors (PPIs) for Helicobacter pylori eradication. This study assessed the comparative effectiveness of vonoprazan- versus dexlansoprazole-based regimens in a real-world clinical setting. Methods We retrospectively analyzed 146 patients (73 per group) receiving vonoprazan- or dexlansoprazole-based therapy. Eradication success rates were compared using both frequency-based and Bayesian methods, with additional risk estimates and time-to-event analyses. Results The vonoprazan group had a higher eradication rate (93.15%, 95% CI: 84.95, 97.04) compared with dexlansoprazole (83.56%, 95% CI: 73.43, 90.34); this difference did not reach statistical significance at the conventional 0.05 level (χ² = 3.262, p = 0.07). Risk ratio (1.11, 90% CI: 1.01, 1.23) and odds ratio (2.68, 90% CI: 1.06, 6.73) estimates using exploratory 90% CIs excluded the null at this wider, non-confirmatory threshold, favoring vonoprazan, though the corresponding 95% CIs remained inconclusive. Bayesian analysis yielded a posterior risk difference of 9.3% (95% credible interval: -1.1, 20.1) and a 96.2% posterior probability that vonoprazan was more effective, though the credible interval still included values close to and below zero. Kaplan-Meier analysis showed a shorter median time to documented confirmation of eradication with vonoprazan (97 days) than with dexlansoprazole (114 days; log-rank p = 0.02), which reflects the timing of documented testing rather than a direct measure of biological eradication speed. Conclusions Vonoprazan was associated with a numerically higher eradication rate and earlier documented confirmation of eradication compared with dexlansoprazole. While the primary comparison did not reach statistical significance at the 95% level, several exploratory analyses, including the 90% CIs and the Bayesian posterior probability, were directionally consistent with a possible advantage for vonoprazan; these findings are hypothesis-generating rather than confirmatory. Larger, multicenter, prospective studies are warranted to confirm these results.
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BibTeX
@article{prasad2026comparative,
title = {{Comparative Analysis of Vonoprazan- and Dexlansoprazole-Based Therapies for Helicobacter pylori Eradication: A Single-Center Retrospective Observational Study.}},
author = {Vg Mohan Prasad and Vamsi Murthy K and Madhura Prasad Suman and Mithra Prasad and Jackson Keefer Jerry},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.117041},
url = {https://europepmc.org/article/MED/42953079},
note = {CC BY},
}
RIS
TY - JOUR
TI - Comparative Analysis of Vonoprazan- and Dexlansoprazole-Based Therapies for Helicobacter pylori Eradication: A Single-Center Retrospective Observational Study.
AU - Vg Mohan Prasad
AU - Vamsi Murthy K
AU - Madhura Prasad Suman
AU - Mithra Prasad
AU - Jackson Keefer Jerry
PY - 2026
DA - 2026/09/27
JO - Cureus
DO - 10.7759/cureus.117041
UR - https://europepmc.org/article/MED/42953079
AB - Background and aim Vonoprazan, a potassium-competitive acid blocker (PCAB), has emerged as an alternative to proton pump inhibitors (PPIs) for Helicobacter pylori eradication. This study assessed the comparative effectiveness of vonoprazan- versus dexlansoprazole-based regimens in a real-world clinical setting. Methods We retrospectively analyzed 146 patients (73 per group) receiving vonoprazan- or dexlansoprazole-based therapy. Eradication success rates were compared using both frequency-based and Bayesian methods, with additional risk estimates and time-to-event analyses. Results The vonoprazan group had a higher eradication rate (93.15%, 95% CI: 84.95, 97.04) compared with dexlansoprazole (83.56%, 95% CI: 73.43, 90.34); this difference did not reach statistical significance at the conventional 0.05 level (χ² = 3.262, p = 0.07). Risk ratio (1.11, 90% CI: 1.01, 1.23) and odds ratio (2.68, 90% CI: 1.06, 6.73) estimates using exploratory 90% CIs excluded the null at this wider, non-confirmatory threshold, favoring vonoprazan, though the corresponding 95% CIs remained inconclusive. Bayesian analysis yielded a posterior risk difference of 9.3% (95% credible interval: -1.1, 20.1) and a 96.2% posterior probability that vonoprazan was more effective, though the credible interval still included values close to and below zero. Kaplan-Meier analysis showed a shorter median time to documented confirmation of eradication with vonoprazan (97 days) than with dexlansoprazole (114 days; log-rank p = 0.02), which reflects the timing of documented testing rather than a direct measure of biological eradication speed. Conclusions Vonoprazan was associated with a numerically higher eradication rate and earlier documented confirmation of eradication compared with dexlansoprazole. While the primary comparison did not reach statistical significance at the 95% level, several exploratory analyses, including the 90% CIs and the Bayesian posterior probability, were directionally consistent with a possible advantage for vonoprazan; these findings are hypothesis-generating rather than confirmatory. Larger, multicenter, prospective studies are warranted to confirm these results.
SN - 2168-8184
ER -