14-day vonoprazan-based dual therapy versus quadruple therapy for H. pylori eradication

Efficacy and Safety of 14-Day Vonoprazan-Based Dual Therapy Versus Quadruple Therapy for Helicobacter Pylori Eradication: A Multicentre, Non-Inferiority Randomized Controlled Trial

Not applicable Interventional Shandong University · NCT07179159

This study will test whether a 14-day vonoprazan plus amoxicillin treatment clears H. pylori as well as two different 14-day vonoprazan-based quadruple regimens in adults with H. pylori infection.

Quick facts

PhaseNot applicable
Study typeInterventional
Enrollment372 (estimated)
Ages18 Years to 70 Years
SexAll
SponsorShandong University Academic / other
Locations2 sites (Jinan, Shandong and 1 other locations)
Trial IDNCT07179159 on ClinicalTrials.gov

What this trial studies

This multicentre, randomized non-inferiority trial will enroll adults aged 18–70 with confirmed H. pylori infection and no prior eradication therapy. Participants will be randomized to 14 days of vonoprazan–amoxicillin dual therapy or to one of two 14-day vonoprazan-based quadruple regimens that add either levofloxacin and bismuth or clarithromycin and bismuth. The primary outcome is H. pylori eradication rate measured after treatment, and secondary outcomes include adverse events and patient adherence. Sites are in Shandong, China, and standard diagnostic tests such as the 13C-urea breath test and confirmatory stool, urease, or histology are used for enrollment and outcome confirmation.

Who should consider this trial

Good fit: Adults 18–70 with laboratory-confirmed H. pylori infection who have not received prior eradication therapy and who do not have severe organ dysfunction or pregnancy are suitable candidates.

Not a fit: Patients with severe hepatic or renal disease, active gastrointestinal bleeding, recent use of antibiotics/bismuth/acid-suppressing agents, prior H. pylori treatment, pregnancy or lactation, or inability/unwillingness to consent are unlikely to benefit from participation.

Why it matters

Potential benefit: If successful, the dual regimen could offer a simpler, lower-drug treatment with similar eradication rates and fewer side effects.

How similar studies have performed: Previous studies, particularly from East Asia, have reported promising eradication rates for vonoprazan–amoxicillin dual therapy, though outcomes vary by regional antibiotic resistance.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

1. Aged 18-70 years, male or female
2. Patients with H. pylori infection (positive 13C-urea breath test, together with at least one positive result from the following three tests: (a) stool H. pylori antigen test; (b) rapid urease test; (c) histopathological examination of gastric mucosal biopsy tissue)
3. No prior Helicobacter pylori eradication therapy

Exclusion Criteria:

1. Severe underlying conditions, such as hepatic insufficiency, renal insufficiency, malignant tumours
2. Active gastrointestinal bleeding
3. History of upper gastrointestinal surgery
4. History of drug hypersensitivity
5. Use of bismuth compounds or antibiotics within the past 4 weeks, or acid-suppressing agents within the past 2 weeks
6. Pregnant or lactating women
7. Presence of other risk-increasing behaviours such as alcohol abuse or illicit drug use
8. Individuals unable or unwilling to provide informed consent

Where this trial is running

Jinan, Shandong and 1 other locations

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions HELICOBACTER PYLORI INFECTIONS
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.