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Tegoprazan-amoxicillin dual therapy shows no difference in H. pylori eradication compared to bismuth quadruple therapyTegoprazan Dual Therapy Shows Similar Success for H. pylori Infection

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Key Takeaway
Consider tegoprazan-amoxicillin dual therapy as a tolerable first-line alternative to bismuth quadruple therapy.

This meta-analysis of randomized controlled trials evaluated the efficacy of a 14-day tegoprazan-amoxicillin dual therapy compared to bismuth-containing quadruple therapy (BQT) for the treatment of Helicobacter pylori infection in 1541 treatment-naïve participants. The primary outcome was intention-to-treat eradication rates.

The analysis found no statistically significant difference in eradication rates between the dual therapy and BQT (risk ratio, 0.996; 95% CI, 0.911-1.089; P=0.93). A sensitivity analysis comparing tegoprazan-amoxicillin to a PPI-based BQT also showed consistent results (risk ratio, 0.985; 95% CI, 0.877-1.107; P=0.80).

Regarding safety, adverse events and treatment discontinuations were reported more frequently in the BQT arms than in the dual-therapy arms. However, the authors noted that reporting of safety and adherence outcomes was not fully standardized across the included studies.

Clinically, these findings suggest that 14-day tegoprazan-amoxicillin dual therapy may serve as an alternative first-line option for H. pylori eradication, particularly in scenarios where regimen simplicity and tolerability are prioritized for the patient.

How this fits prior evidence

This meta-analysis extends prior evidence regarding non-inferior dual-therapy regimens for H. pylori. It specifically builds upon the finding that keverprazan-amoxicillin dual therapy is a non-inferior first-line option compared to esomeprazole-amoxicillin. This new data confirms that tegoprazan-amoxicillin also shows no significant difference in eradication rates compared to bismuth-containing quadruple therapy (risk ratio, 0.996; 95% CI, 0.911-1.089; P=0.93).

Researchers analyzed data from 1,541 people to compare two different ways of treating a common stomach bacteria called H. pylori. One group received a 14-day dual therapy of tegoprazan and amoxicillin. The other group received a standard quadruple therapy that included bismuth. The goal was to see if the simpler dual therapy could work as well as the standard treatment.

The results showed that both treatment methods were equally effective at clearing the infection. The study found no significant difference in eradication rates between the two groups. This suggests that the shorter, simpler regimen might be just as effective as the more complex standard treatment.

Safety data also showed that patients on the dual therapy reported fewer side effects and fewer instances of stopping their medication compared to those on the quadruple therapy. While the results are promising, the study noted that reporting for some safety outcomes was not fully standardized. This finding suggests that a simpler dual therapy could be a helpful option for patients who prefer a shorter or easier treatment plan.

What this means for you:
A 14-day tegoprazan and amoxicillin dual therapy is as effective as standard treatment for H. pylori infections.

Common questions

Is the tegoprazan dual therapy as effective as standard treatment?

Yes, the study of 1,541 participants found no statistically significant difference in eradication rates between the 14-day tegoprazan-amoxicillin dual therapy and the bismuth-containing quadruple therapy. Both methods were equally effective at clearing the H. pylori infection.

Are there fewer side effects with the dual therapy?

The study reported that adverse events and treatment discontinuations occurred more frequently in the quadruple therapy group than in the dual-therapy group. This suggests the tegoprazan-amoxicillin combination may be easier for some patients to tolerate.

How long is the tegoprazan treatment course?

The study specifically looked at a 14-day tegoprazan-amoxicillin dual therapy. This shorter course was compared against a standard quadruple therapy to see if it could serve as a simpler first-line option for patients.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedNov 2026
View Original Abstract ↓
Optimized bismuth quadruple therapy is a recommended first-line treatment for Helicobacter pylori infection but is limited by regimen complexity, whereas tegoprazan-amoxicillin dual therapy has emerged as a simplified alternative with limited comparative evidence. We conducted a systematic review and meta-analysis of randomized controlled trials comparing tegoprazan-amoxicillin dual therapy with bismuth-containing quadruple therapy (BQT) as first-line treatment for H. pylori infection. Electronic databases (PubMed, Embase, Web of Science Core Collection, and the Cochrane Library) were searched from inception through 24 December 2025. Intention-to-treat eradication rates were pooled using a random-effects model. Sensitivity analyses were performed by restricting comparators to proton pump inhibitor-based BQT. Safety outcomes were qualitatively synthesized. Five randomized controlled trials involving 1541 treatment-naïve participants were included. In intention-to-treat analyses, 14-day tegoprazan-amoxicillin dual therapy showed no statistically significant difference in eradication efficacy compared with BQT [risk ratio, 0.996; 95% confidence interval, 0.911-1.089; P = 0.93]. Sensitivity analysis restricted to proton pump inhibitor-based BQT yielded consistent results (risk ratio, 0.985; 95% confidence interval, 0.877-1.107; P = 0.80). Across individual studies, adverse events and treatment discontinuation were generally reported more frequently in BQT arms than in dual-therapy arms, although reporting of safety and adherence outcomes was not fully standardized. In randomized first-line trials, 14-day tegoprazan-amoxicillin dual therapy demonstrated eradication efficacy comparable to BQT. These findings suggest that 14-day tegoprazan-amoxicillin dual therapy may serve as an alternative first-line option, particularly when regimen simplicity and tolerability are prioritized.
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