Home›Infectious Disease› Keverprazan-amoxicillin dual therapy shows non-inferior H. pylori eradication versus esomeprazole-amoxicillin
Keverprazan-amoxicillin dual therapy shows non-inferior H. pylori eradication versus esomeprazole-amoxicillinNew drug shows promise for treating H. pylori infections
Annals of medicinePublished August 11, 2026Study authors: Ma Zhaoli, Gou Xi, Ma Hongjuan, Lu Hong, Liu Min, Yuan Hao, Li Qiang, Wang Jun, Yang Huizhen, Wang Y…PubMed ↗DOI ↗Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease
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Key Takeaway
Consider keverprazan-amoxicillin dual therapy as a non-inferior first-line option for H. pylori in Chinese adults.
In a prospective, multicenter randomized controlled trial, 264 treatment-naive adults with H. pylori infection were randomized to receive either 14-day KA therapy (keverprazan 20 mg b.i.d plus amoxicillin 1 g t.i.d) or 14-day EA therapy (esomeprazole 40 mg b.i.d plus amoxicillin 1 g t.i.d). The primary outcome was eradication rate, with secondary outcomes including adverse events and adherence.
Eradication rates were numerically higher in the KA group across all analyses: 87.9% versus 80.3% in the intention-to-treat (ITT) analysis (p=0.092), 92.1% versus 86.2% in the modified ITT analysis (p=0.135), and 93.5% versus 88.3% in the per-protocol analysis (p=0.155). The non-inferiority of KA to EA was confirmed (p<0.001).
Adverse events were similar between the two groups, and KA demonstrated good tolerability. Serious adverse events and discontinuations were not reported. The study did not report funding or conflicts of interest.
Limitations were not reported in the input, but the study specifically mentions the Chinese population in its conclusion, so generalizability to other populations may be limited. The trial design supports the efficacy of KA over EA for eradication, with high certainty for non-inferiority.
For clinicians, KA appears to be a rational first-line alternative to EA in the Chinese population, offering comparable eradication with a simplified regimen. However, the lack of statistical superiority and the population-specific context should be considered when applying these results broadly.
How this fits prior evidence
This trial extends prior coverage of potassium-competitive acid blocker (P-CAB) dual therapies for H. pylori. It aligns with the July 2026 finding that vonoprazan-amoxicillin dual therapy is a safe alternative to bismuth-containing quadruple therapy, and with the August 2026 finding that tegoprazan-amoxicillin dual therapy matches quadruple efficacy with fewer adverse events. Here, keverprazan-amoxicillin shows non-inferiority to esomeprazole-amoxicillin, reinforcing the role of P-CAB-based dual therapy. It also complements the July 2026 note on region-specific antibiotic resistance, as this study was conducted in China, where resistance patterns may differ from other regions.
Living with an H. pylori infection can be a persistent challenge for your digestive health. Researchers recently tested a new treatment option called Keverprazan combined with amoxicillin to see how it stacks up against the current standard, which uses esomeprazole and amoxicillin.
The study followed 264 adults who had never been treated for the infection before. The results showed that the newer combination reached eradication rates of 87.9% compared to 80.3% for the standard treatment. While these numbers were higher for the new drug, the difference was not statistically significant in some specific analyses.
Safety is a major factor when choosing a treatment plan. Patients who took the newer Keverprazan combination reported good tolerability and had similar side effects to those on the standard medicine. The study confirms that this new option is a reliable alternative for patients, particularly within the Chinese population.
What this means for you:
Keverprazan combined with amoxicillin is an effective and well-tolerated way to clear H. pylori infections.
Common questions
Is the new Keverprazan treatment safe?
Yes, the study reported that the Keverprazan combination had good tolerability. Patients who took it experienced a similar number of side effects compared to those taking the standard esomeprazole treatment.
How effective is Keverprazan at clearing H. pylori?
The study found that 87.9% of patients were successfully treated with the Keverprazan and amoxicillin combination, which was higher than the 80.3% success rate seen in the group taking esomeprazole.
How does this compare to current treatments?
The study confirmed that Keverprazan is not inferior to the standard esomeprazole treatment. It serves as a reliable first-line alternative for patients who need to clear an H. pylori infection.
BACKGROUND: Keverprazan offers a new perspective for eradication. This study compared 14-day keverprazan-amoxicillin therapy with esomeprazole-amoxicillin therapy to explore a superior treatment strategy.
METHODS: This was a prospective, open-label, multicenter, randomized controlled trial in adult patients with treatment-naive infection. Participants were randomly assigned to receive either 14-day of KA therapy (Keverprazan 20 mg b.i.d plus amoxicillin 1 g t.i.d) or 14-day of EA therapy (Esomeprazole 40 mg b.i.d plus amoxicillin 1 g t.i.d). The primary outcome was the eradication rate. Secondary outcomes were the incidence of adverse events and patient adherence.
RESULTS: A total of 264 patients were enrolled in the study. In the intention-to-treat (ITT) analysis, the eradication rates for the 14-day KA group and the 14-day EA group were 87.9% and 80.3%, respectively ( = 0.092); in the modified intention-to-treat (mITT) analysis, the eradication rates were 92.1% and 86.2%, respectively ( = 0.135); and in the per-protocol (PP) analysis, the eradication rates were 93.5% and 88.3%, respectively ( = 0.155). Non-inferiority was confirmed between the two groups (all < 0.001). Adverse events and patient adherence were similar between the two groups.
CONCLUSION: For treatment-naive infection, the 14-day KA therapy is non-inferior to EA therapy. Given its good tolerability, pharmacogenomic independence, and potent acid suppression, KA is a rational first-line alternative to EA in the Chinese population.
