Safety and effectiveness of dual therapy for Helicobacter pylori infection and the effect on the glycated hemoglobin level in type 2 diabetes

Patients with diabetes have a high risk of failure of H . pylori eradication therapy. The present study aims to evaluate the efficacy and safety of vonoprazan–amoxicillin (VA) dual therapy for the treatment of H . pylori infection in patients with type-2 diabetes mellitus (T2DM), and determine the influence of H . pylori eradication on the glycated hemoglobin A1C (A1C) level. The present prospective, single-center, single-arm, clinical trial enrolled 75 T2DM patients diagnosed with H . pylori infection. The patients were treated with the VA dual therapy regimen, which comprised of vonoprazan (20 mg, twice daily) and amoxicillin (750 mg, thrice daily), for 14 days (14-day VA dual therapy). The eradication rate in the intention-to-treat analysis and per-protocol analysis was 84.00% (63/75) and 87.14% (61/70), respectively. The multivariate analysis revealed that the independent risk factors for H . pylori eradication failure were smoking (OR: 4.59, 95% CI: 1.20–17.58, p = 0.026) and elevated A1C level (OR: 1.65, 95% CI: 1.01–2.68, p = 0.044). Patients in the successful eradication group presented with a significant decrease in the A1C level at 3 months, post-treatment, when compared to the pre-eradication level (7.70 ± 1.05% vs. 7.23 ± 1.00%, p = 0.006). VA dual therapy is a safe and effective regimen for patients with T2DM.