Rabeprazole 10mg gastro-resistant tablets

BackgroundErosive esophagitis (EE) is commonly managed with proton pump inhibitors (PPIs), yet many patients experience incomplete healing or recurrence. Potassium-competitive acid blockers (P-CABs) have emerged as potential alternatives, but high-certainty comparative evidence across agents remains limited. We performed a network meta-analysis to evaluate the relative efficacy and safety of P-CABs versus PPIs and to assess the certainty of the evidence.MethodsWe systematically searched PubMed, the Cochrane Library, and Web of Science from inception through March 1, 2025, for randomized controlled trials (RCTs) comparing P-CAB, PPI, and/or placebo for the treatment of EE. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. Key outcomes were 8-week endoscopic healing and 24-week recurrence. Certainty of evidence was evaluated using GRADE. Risk difference (RD) estimates were calculated using random-effects models. The study protocol was registered with PROSPERO (CRD420251116179).FindingsThirty-nine RCTs were included; all evaluated once-daily dosing. At 8 weeks, zastaprazan 20 mg, vonoprazan 20 mg, and esomeprazole 40 mg demonstrated moderate-certainty superiority over rabeprazole 20 mg and omeprazole 20 mg with RDs ranging from 0.05 to 0.11, while only vonoprazan 20 mg demonstrated moderate-certainty benefit versus lansoprazole 30 mg (RD: 0.04). In Los Angeles (LA) grade C/D EE, vonoprazan 20 mg, esomeprazole 40 mg, and rabeprazole-ER 50 mg demonstrated moderate-to-high-certainty benefit over lansoprazole 30 mg and omeprazole 20 mg with RDs ranging from 0.05 to 0.15. Vonoprazan 20 mg and rabeprazole-ER 50 mg demonstrated moderate-certainty benefit compared with pantoprazole 40 mg (RDs: 0.12 and 0.09, respectively).At 24 weeks, vonoprazan 10 mg and 20 mg showed moderate-to-high-certainty benefit versus lansoprazole 15 mg (RDs: -0.11 and -0.13, respectively), while in direct comparisons, esomeprazole 20 mg outperformed lansoprazole 15 mg and pantoprazole 20 mg, with approximately 40-50% relative reductions in recurrence. In LA grade C/D EE, vonoprazan 10 mg and 20 mg demonstrated moderate-to-high-certainty superiority over lansoprazole 15 mg and pantoprazole 20 mg with RDs ranging from -0.12 to -0.20. Esomeprazole 20 mg showed a high-certainty benefit compared with pantoprazole 20 mg (RD: -0.16). At 8 and 24 weeks, safety profiles were generally comparable between P-CABs and PPIs.InterpretationAmong once-daily regimens, vonoprazan 20 mg, zastaprazan 20 mg, and esomeprazole 40 mg were most effective for healing EE, while vonoprazan 10 mg and 20 mg and esomeprazole 20 mg were most effective in preventing recurrence. Benefits were most pronounced in LA grade C/D EE and are supported by moderate to high-certainty evidence. Comparative trials evaluating newer P-CABs against optimized PPI strategies, including twice-daily dosing, are needed to evaluate efficacy and long-term safety, particularly with respect to hypergastrinemia and infection risk.FundingNone was received for the study.

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BackgroundIncreasing antibiotic resistance compromises therapeutic options for Helicobacter pylori (H. pylori) infection, especially in penicillin-allergic individuals.ObjectivesThis trial aimed to assess the efficacy and safety of 14-day vonoprazan-minocycline (VM) dual therapy against bismuth-containing quadruple therapy (B-quadruple therapy), as initial treatment for H. pylori infection.DesignThis study was a single-center, open-label, and non-inferiority randomized controlled trial.MethodsIn this study, 240 individuals with H. pylori infection who have not received therapy were randomly assigned 1:1 to either the VM dual therapy group (vonoprazan 20 mg plus minocycline 100 mg, administered twice daily) or the B-quadruple therapy group (rabeprazole 10 mg, amoxicillin 1000 mg, clarithromycin 500 mg, and bismuth potassium citrate 220 mg, all administered twice daily). The primary outcome was to evaluate the non-inferiority of eradication rates between the two groups. Secondary outcomes included assessments of AEs and compliance.ResultsThe eradication rates of VM dual group and B-quadruple therapy group were 87.5% and 88.3%, respectively, by intention-to-treat (ITT) analysis; 92.1% and 94.6% by modified ITT (mITT) analysis; and 92.0% and 95.5% by per-protocol (PP) analysis. The eradication rates of the VM group were non-inferior to those of the B-quadruple therapy group in ITT, mITT, and PP analyses (one-sided p-values were 0.02, 0.01, and 0.02). The incidence of AEs was higher in the B-quadruple therapy group (28.3%) than in the VM group (16.7%, p = 0.03). Good compliance was achieved in both groups (p = 0.60).ConclusionThe VM dual therapy was not inferior to the B-quadruple therapy in the initial treatment of H. pylori infection, and the incidence of AEs was lower compared to B-quadruple therapy.Trial registrationThis trial was registered on the Chinese Clinical Trial Registry with the registration number ChiCTR2400081461.

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BACKGROUND: Both traditional proton pump inhibitors and the novel potassium-competitive acid blocker vonoprazan, when combined with high-dose amoxicillin in dual therapy, have shown promise for Helicobacter pylori (H. pylori) eradication. However, high-quality evidence directly comparing their efficacy and safety remains limited. This study aimed to compare the clinical efficacy and safety of rabeprazole-amoxicillin dual therapy versus vonoprazan-amoxicillin dual therapy for H. pylori eradication. METHODS: From April 1, 2024, to February 28, 2025, 318 H. pylori-positive patients were enrolled and randomly assigned in a 1:1 ratio to two treatment groups: the Rabeprazole Group (rabeprazole 20 mg twice daily; amoxicillin 1000 mg three times daily) and the Vonoprazan Group (vonoprazan 20 mg twice daily; amoxicillin 1000 mg three times daily). Both groups received a 14-day treatment course. A 13C-urea breath test was performed at least four weeks after treatment completion. H. pylori eradication rates, incidence of adverse events during treatment, and medication adherence were compared between the groups. RESULTS: In the intention-to-treat analysis, the eradication rates were 75.5% (95% CI: 68.8%-82.2%) in the Rabeprazole Group and 83.0% (95% CI: 77.2%-88.9%) in the Vonoprazan Group, with no statistically significant difference (P = 0.097). In the modified intention-to-treat analysis, the rates were 78.4% (95% CI: 71.9%-84.9%) and 88.6% (95% CI: 83.5%-93.7%), respectively, showing a significant difference (P = 0.018). In the per-protocol analysis, the rates were 79.7% (95% CI: 73.1%-86.3%) and 90.1% (95% CI: 85.1%-95.0%), respectively, also showing a significant difference (P = 0.015). The incidence of adverse events was low in both groups (10.5% vs. 12.8%, P = 0.533). Medication adherence did not differ significantly between the groups (P = 0.648). Manual labor occupation was identified as a risk factor for eradication failure (adjusted OR = 2.153, 95% CI: 1.067 to 4.346, P = 0.032). CONCLUSION: Vonoprazan-amoxicillin dual therapy achieves satisfactory outcomes for H. pylori eradication, with a significantly higher eradication rate than the traditional rabeprazole-amoxicillin dual regimen. As a novel acid suppressant, vonoprazan demonstrates significant clinical advantages and broad application potential in dual-therapy regimens for H. pylori eradication. CLINICAL TRIAL REGISTRATION: https://www.medicalresearch.org.cn/ , identifier ChiCTR2400082319. Registered on March 5, 2024.

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BackgroundThe aim of this study is to optimize Helicobacter pylori (H. pylori) eradication by increasing the proton pump inhibitor (PPI) dose and reducing the treatment duration of antibiotics without compromising the treatment's safety and efficacy.MethodsThis pilot randomized controlled trial included 120 patients from Notre Dame des Secours University Hospital in Byblos, Lebanon, between February 2023 and December 2023. Participants were Lebanese adults with H. pylori infection confirmed by upper gastrointestinal endoscopy. Exclusion criteria included pregnancy or nursing, malignancy or gastric mucosa-associated lymphoid tissue lymphoma, allergy or contraindications to study drugs, active upper gastrointestinal bleeding, prior gastric surgeries, recent use of PPIs or antibiotics, celiac disease, previous H. pylori treatment, or refusal to consent. Eligible patients (n = 113) were randomly assigned into three groups: Group A (n = 38) received a standard-dose of rabeprazole 20 mg twice daily for 14 days with concomitant therapy, Group B (n = 37) received a double-dose of rabeprazole (20 mg twice per day) for 10 days with concomitant therapy, and Group C (n = 38) received a high-dose of rabeprazole (20 mg three times per day) for 10 days with concomitant therapy. Eradication was assessed by urea breath test six weeks after treatment completion.ResultsOut of 120 participants, 101 patients were considered for analysis, while 19 patients were excluded (15.8%). Of these exclusions, 7 patients were excluded before randomization due to drug allergy and opted for alternative treatment (5.8%), while 12 were excluded after randomization due to loss to follow-up (12%). The results indicated that the high-dose PPI group C had the highest percentage of negative breath tests (100%), followed by the standard treatment group A with 94.7%, and then group B with 83.3%. However, given the pilot nature and sample size of this study, these results, particularly the 100% rate in Group C, should be interpreted as preliminary and require confirmation in a larger trial.ConclusionThe use of high-dose PPI with 10 days of concomitant therapy (Group C) demonstrated the highest eradication rate among the study groups. This promising finding suggests a potential benefit of the high-dose PPI regimen with 10-day concomitant therapy but must be interpreted with caution; it warrants further investigation in a larger and adequately powered randomized controlled trial to confirm its efficacy and generalizability, given the pilot nature of this study.Name of the registryLebanon clinical trial registry; TRAIL REGISTRATION NUMBER: LBCTR2025075755; DATE OF REGISTRATION IN PRIMARY REGISTRY: 14/08/2025.

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