Efficacy and safety of vonoprazan-based dual therapy and esomeprazole-based dual therapy in eradicating primary Helicobacter pylori infection: A propensity score matching analysis.

BACKGROUND: According to the Maastricht VI/Florence consensus report, potassium-competitive acid blockers (P-CAB) may improve Helicobacter pylori eradication treatment. MATERIALS AND METHODS: A total of 213 H. pylori treatment-naive patients aged between 18 and 70 years were treated with two regimens. The two regimens are VDT: 20 mg vonoprazan twice a day and 1 g amoxicillin three times daily and EDT: 20 mg esomeprazole four times a day and 750 mg amoxicillin four times daily. 13 C-urea breath tests were used to evaluate eradication rate 4-6 weeks after treatment. Based on propensity score matching (PSM), this retrospective study analyzed the eradication rates, adverse events (AEs), compliance, and antibiotic resistance rates in VDT and EDT groups. RESULTS: On intention-to-treat (ITT) analysis, the eradication rate in VDT group (89.0%; 95% CI 81.7-96.3) was non-inferior to that in EDT group (87.7%; 95% CI 80.1-95.3; p = 0.796). The corresponding per-protocol (PP) eradication rates were 94.1% (95% CI 88.4-99.8) and 92.8% (95% CI 86.7-98.9; p = 1.000), respectively. There were no significant between-group differences with respect to compliance or incidence of AEs. CONCLUSIONS: The efficacy and safety of 14-day VDT and EDT were comparable. Therefore, 14-day VDT or EDT may be recommended for the first-line treatment of H. pylori infection.

The selective encapsulation and stabilization of cinnamaldehyde and eugenol in high internal phase Pickering emulsions: Regulating the interfacial properties.

This work aimed to investigate the encapsulation and stabilization mechanism of cinnamaldehyde and eugenol in high internal phase Pickering emulsions (HIPPEs) through regulating their interfacial rheological properties and interfacial microstructure. With the incorporation of cinnamaldehyde, the Schiff base reaction between the cinnamaldehyde and proteins favored the formation of the predominantly elastic and solid-like interfacial layers. In contrast, the hydrogen bonds between eugenol and proteins resulted in the transformation of interfacial layers to viscous dominant with weak viscoelastic responses. Thus, cinnamaldehyde-loaded HIPPEs had a better storage stability than eugenol-loaded HIPPEs, and the retention rate was increased by about 15 %∼20 %. The addition of tea camellia seed oil inhibited the mobility of immobilized water and improved the retention rates of cinnamaldehyde and eugenol by approximately 6 % and 12 % (30 days at 25 °C), respectively. These findings will be beneficial for the development and design of effective essential oil encapsulation systems in the food industry.

High internal phase pickering emulsions stabilized by pea protein isolate-high methoxyl pectin-EGCG complex: Interfacial properties and microstructure.

The pea protein isolate-high methoxyl pectin-epigallocatechin gallate (PPI-HMP-EGCG) complex was used to stabilize Pickering emulsions (PEs) and high internal phase PEs (HIPPEs), and the effect of interfacial rheology on the microstructure, bulk rheology and stability of these emulsions was investigated. The PPI-HMP-EGCG complex with PPI to EGCG 30:1 exhibited partial wettability (81.6 ± 0.4°) and optimal viscoelasticity for the formation of stable interfacial layer. The microstructure demonstrated that the PPI-HMP-EGCG complex acted as an interfacial layer and surrounded the oil droplets, and continuous phases were mainly filled with excessive HMP, which enhanced emulsion stability. The formation of a firm gel-like network structure required a dense interfacial layer to provide the PEs (complex concentration of 0.1%) and HIPPEs (oil-phase up to 0.83) with ideal viscoelasticity and stability. The results provide the guidelines for the rational design of EGCG-loaded HIPPEs stabilized by water-soluble protein/polysaccharide complexes.

Eradication Efficacy of Modified Dual Therapy Compared with Bismuth-Containing Quadruple Therapy as a First-Line Treatment of Helicobacter pylori.

OBJECTIVES: This study assessed the effectiveness, adverse events, patient adherence, and costs of modified dual therapy compared with bismuth-containing quadruple therapy for treating Helicobacter pylori infection in Chinese patients. We also sought to determine whether modified dual therapy could be used as an alternative first-line treatment for H. pylori infection. METHODS: A total of 232 H. pylori-infected, treatment-naive patients were enrolled in this open-label, randomized controlled clinical trial. Patients were randomly allocated into 2 groups: the 14-day modified dual therapy group and the bismuth-containing quadruple therapy group. Eradication rates, drug-related adverse events, patient compliance, and drug costs were compared between the 2 groups. RESULTS: The modified dual therapy group achieved eradication rates of 87.9%, 91.1%, and 91.1% as determined by the intention-to-treat, per-protocol, and modified intention-to-treat analyses, respectively. The eradication rates were similar compared with the bismuth-containing quadruple therapy group: 89.7%, 91.2%, and 90.4%. In addition, modified dual therapy ameliorated variations in the CYP2C19, IL-1B-511, and H. pylori VacA genotypes. There were no significant differences in the compliance rates between the 2 groups. The modified dual therapy group exhibited significantly less overall side effects compared with the bismuth-containing quadruple therapy group (P < 0.001). Furthermore, the cost of medications in the modified dual therapy was lower compared with that in the bismuth-containing quadruple therapy. CONCLUSIONS: Modified dual therapy at high dose and administration frequency is equally effective and safer and less costly compared with bismuth-containing quadruple therapy.