As per the findings of a retrospective study, the helicobacter pylori (H. pylori) elimination success rates of tegoprazan and lansoprazole-based first-line triple therapy regimen for seven days was found to exceed 82% with acceptable tolerability when given with bismuth in elimination-naive people. Investigators undertook this study for investigating the efficacy and safety of a proton pump inhibitor (PPI)-based first-line therapy with bismuth in comparison with potassium-competitive acid blocker (P-CAB)-based first-line elimination therapy with bismuth in elimination-naive H. pylori-infected people.

Prior to approval of the P-CAB-based elimination therapy, twice-daily administration of a regimen containing 30 mg lansoprazole, 1 g amoxicillin, 500 mg clarithromycin, and 300 mg bismuth potassium citrate was prescribed for seven days. Following approval, 30 mg lansoprazole was replaced with 50 mg tegoprazan. Examination of clarithromycin resistance was done in people who underwent gastroscopic biopsy. With the aid of the 13C-urea breath test, efficacy was assessed.

Of 381 eradication-naive subjects, the elimination rate of H. pylori in the tegoprazan group and  lansoprazole group is shown in Table 1:

Clarithromycin resistance was noted in 30 (20.1%) of the 148 people (74 from each arm), and only 4 of the 16 clarithromycin-resistant people in the tegoprazan arm attained successful H. pylori elimination. No severe adverse effects were witnessed. For elimination failure, poor patient compliance (odds ratio [OR] =17.1) and clarithromycin resistance (OR= 42.1) were the independent risk factors.

Nevertheless, efficacy was found to be limited in clarithromycin-resistant strains since neither 30 mg lansoprazole nor 50 mg tegoprazan attained acceptable elimination rates when given twice daily for seven days in clarithromycin-resistant people.