奈良県の高齢化地域におけるボノプラザンを用いたヘリコバクター・ピロリ除菌に関する検討

Abstract

Introduction: There are few reports on the efficacy and safety of vonoprazan (P-CAB) based triple eradication therapy in the elderly. In this study, we investigated the efficacy and safety of P-CAB based eradication of Helicobacter pylori (H. pylori) in non-elderly and elderly patients in our community, where the elderly population is high (41.7%). Methods: 205 patients who underwent primary and secondary eradication for H. pylori at our hospital from October 2018 to December 2020, were included in this study. Results: In primary eradication, the success rate for eradication in non-elderly and elderly patients was 96.6% (57 of 59 patients) and 88.7% (110 of 124 patients) respectively (P=0.10). The success rate for eradication in the late-elderly was 90.2% (46 of 51 patients). There was no significant difference compared with non-elderly patients (P = 0.25). The success rates for secondary eradication in non-elderly and elderly patients were 100% (7 of 7 patients) and 66.7% (10 of 15 patients). respectively, with no significant difference between the two groups (P = 0.13). The success rate for eradication in the late-elderly was low (40.0%: 2 of 5 cases). and there was significant difference compared with that in the non-elderly (P < 0.05). In the primary eradication, there was only one case of death from other diseases in the late-elderly patients during the first week after treatment. Discussion: In the elderly, the efficacy of primary eradication was similar to that for the non-elderly, and the frequency of incidental disease was low. Although the efficacy of secondary eradication was lower in the elderly, it was a safe treatment.