Vonoprazan and amoxicillin dual therapy as the first-line treatment of Helicobacter pylori infection: A systematic review and meta-analysis.

BACKGROUND: Recent clinical trials have evaluated the efficacy of vonoprazan-amoxicillin (VA) dual therapy as the first-line treatment for Helicobacter pylori infection in different regions with inconsistent results reported. In this systematic review and meta-analysis, we aimed to evaluate the efficacy of VA dual therapy compared to the currently recommended therapy for eradicating H. pylori. MATERIALS AND METHODS: A comprehensive search of the PubMed, Cochrane, and Embase databases was performed using the following search terms: ("Helicobacter" OR "H. pylori" OR "Hp") AND ("vonoprazan" OR "potassium-competitive acid blocker" OR "P-CAB") AND ("amoxicillin" OR "penicillin") AND ("dual"). The primary outcome was to evaluate the eradication rate according to intention-to-treat and per-protocol analysis. The secondary outcomes were adverse events and compliance. RESULTS: A total of 15 studies involving 4, 568 patients were included. The pooled eradication rate of VA dual therapy was 85.0% and 90.0% by intention-to-treat and per-protocol analysis, respectively. The adverse events rate and compliance of VA dual therapy were 17.5% and 96%, respectively. The efficacy of VA dual therapy was superior to proton pump inhibitors-based triple therapy (82.0% vs. 71.4%, p < 0.01) but lower than vonoprazan-containing quadruple therapy (83.1% vs. 93.3%, p = 0.02). 7-day VA dual therapy showed lower eradication rates than 10-day (χ2 = 24.09, p < 0.01) and 14-day VA dual therapy (χ2 = 11.87, p < 0.01). The adverse events rate of VA dual therapy was lower than vonoprazan triple therapy (24.6% vs. 30.9%, p = 0.01) and bismuth-containing quadruple therapy (20.5% vs. 47.9%, p < 0.01). No significant difference of compliance was observed between VA dual therapy and each subgroup. CONCLUSION: VA dual therapy, a novel regimen, showed high efficacy as the first-line treatment for H. pylori eradication, which should be optimized before application in different regions.

Research trends on nanomaterials in gastric cancer: a bibliometric analysis from 2004 to 2023.

BACKGROUND: Gastric cancer is one of the leading causes of cancer-related deaths worldwide. In recent years, an increasing number of studies aimed at designing and developing nanomaterials for use in diagnosing and treating gastric cancer have been conducted. In this study, we aimed to comprehensively assess the current status and trends of the research on the application of nanomaterials in gastric cancer through a bibliometric analysis. METHODS: Studies focusing on nanomaterials and gastric cancer were retrieved from the Web of Science Core Collection database and relevant articles were selected for inclusion in the study according to the inclusion criteria. Bibliometric and visual analysis of the included publications was performed using VOSviewer and CiteSpace. RESULTS: A total of 793 studies were included. An increase in annual publications was observed from 2004 to 2023. China, Iran and the USA were the dominant countries in this field, accounting for 66.1%, 11.5% and 7.2% of publications, respectively. Shanghai Jiao Tong University and Cui DX were the most influential institution and author, respectively. The International Journal of Nanomedicine was the most prolific journal; Biomaterials was the most cited and most cocited journal. Nanomaterial-related drug delivery and anticancer mechanisms were found to be the most widely researched aspects, and green synthesis and anticancer mechanisms are recent research hotspots. CONCLUSION: In this study, we summarized the characteristics of publications and identified the most influential countries, institutions, authors, journals, hot topics and trends regarding the application of nanomaterials in gastric cancer.