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Reply to the letter by Dr Graham concerning ethical and interpretation issues with vonoprazan-containing H. pylori eradication therapy
  1. Kazunari Murakami1,
  2. Yuuichi Sakurai2,
  3. Madoka Shiino2,
  4. Nobuo Funao2,
  5. Akira Nishimura2,
  6. Masahiro Asaka3
  1. 1 Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
  2. 2 Takeda Pharmaceutical Company Ltd., Osaka, Japan
  3. 3 Health Sciences University of Hokkaido, Hokkaido, Japan
  1. Correspondence to Professor Masahiro Asaka, Health Sciences University of Hokkaido, 1757 Kanazawa, Tobetsu-cho, Ishikari-gun, Hokkaido 061-0293, Japan; maasaka{at}

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We thank Dr Graham for his interest in our article.1 ,2 In Japan, 7 days administration of PPI+amoxicillin+clarithromycin is standard treatment for Helicobacter pylori eradication3 and is the only approved treatment as first-line therapy in Japan. Therefore, there is no ethical issue in increasing sample size to match the current eradication rate. In a blinded interim analysis, the overall eradication rate was 81.6%, which was a lower rate than 90% that …

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  • Contributors KM, YS, MS, NF, AN and MA wrote and approved the author's response to the Letter by Dr Graham.

  • Competing interests KM and MA are independent medical consultants providing expert advice to Takeda Pharmaceutical Company Ltd. YS, MS, NF and AN are employees of Takeda Pharmaceutical Company Ltd.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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