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Tegoprazan vs. esomeprazole/sodium bicarbonate for H. pylori management

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Created On: 06/01/2026

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Key take away

In patients with H. pylori, tegoprazan-based triple therapy shows comparable eradication rates to esomeprazole/sodium bicarbonate-based triple therapy.

Background

Potassium-competitive acid blockers (PCABs) and proton pump inhibitors (PPIs) combined with sodium bicarbonate are widely used to rapidly elevate intragastric pH levels for managing acid-related conditions. This study determined clinical effectiveness and safety outcomes of tegoprazan-based triple therapy versus esomeprazole/sodium bicarbonate-based triple therapy for Helicobacter pylori (H. pylori) infection.

Method

A retrospective review was performed on 854 patients diagnosed with H. pylori infection who received either a 14-day tegoprazan triple therapy regimen (n=435) or a 14-day esomeprazole/sodium bicarbonate triple therapy (n=419). The primary outcome was the first-line H. pylori elimination rate using an intention-to-treat (ITT) analysis. Secondary outcomes included eradication success in the per-protocol (PP) analysis and the rate of treatment-related adverse effects.

Result

Both treatment strategies illustrated similar H. pylori eradication rates in ITT and PP analyses. However, gastrointestinal adverse events (like abdominal discomfort, diarrhea) were more common among those treated with esomeprazole/sodium bicarbonate-based triple therapy (Table 1).

Conclusion

Both tegoprazan-based triple therapy and esomeprazole/sodium bicarbonate-based triple therapy showed similar effectiveness in attaining H. pylori eradication. However, patients receiving esomeprazole/sodium bicarbonate experienced a higher incidence of gastrointestinal adverse effects, particularly abdominal discomfort and diarrhea, suggesting that tegoprazan may offer a more favorable safety profile.