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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. 1Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
  2. 2Takeda Pharmaceutical Company Ltd., Osaka, Japan
  3. 3Health 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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