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We read with great interest the article by Murakami et al,1 who performed a randomised, double-blinded study of vonoprazan-based Helicobacter pylori (H. pylori) eradication therapy. They showed high success rates for vonoprazan-based first-line and second-line H. pylori treatments, with eradication rates of 92.6% and 98%, respectively. However, the study populations of second-line therapy included patients for whom both lansoprazole-based and vonoprazan-based first-line treatments failed, and those for whom vonoprazan-based first-line therapy failed numbered only 14. In terms of second-line therapy, we think that the eradication rate in patients for whom vonoprazan-based first-line therapy failed is more important.
We conducted …