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A comprehensive meta-analysis found that 14-day tegoprazan–amoxicillin dual therapy achieved H. pylori eradication rates comparable to BQT, reinforcing its potential as a simpler first-line treatment option without compromising efficacy.
A pooled analysis of five randomized controlled trials (RCTs) involving 1,541 treatment-naïve patients demonstrated that tegoprazan–amoxicillin dual therapy performed on par with standard bismuth-containing quadruple therapy (BQT) for first-line Helicobacter pylori (H. pylori) eradication. The intention-to-treat (ITT) analysis showed no vital difference in therapeutic success between the two regimens. These findings remained consistent when the assessment was limited to proton pump inhibitor (PPI)-based BQT studies, strengthening confidence in the robustness of the results.
The findings stemmed from a systematic review of RCTs identified through PubMed, Embase, Web of Science Core Collection, and the Cochrane Library up to 24 December 2025. Investigators pooled eradication outcomes using a random-effects model, while safety data, including adverse events were analyzed. Treatment discontinuation was assessed qualitatively because of variability in reporting across the included studies.
The analysis addressed an important clinical question as BQT, despite being the recommended first-line regimen, continues to pose practical challenges in routine care. Its four-drug composition and complex dosing schedule can reduce treatment adherence and increase the burden of therapy. Tegoprazan–amoxicillin dual therapy has emerged as a simplified alternative, but comparative evidence against standard BQT has been limited until now.
Across the included trials, adverse events and treatment discontinuation were generally more common in BQT groups than in patients receiving tegoprazan–amoxicillin dual therapy. Safety and adherence reporting varied among studies, limiting quantitative comparisons of tolerability. Taken together, the evidence indicated that simplifying the eradication regimen did not compromise clinical effectiveness.
The research team concluded that 14-day tegoprazan–amoxicillin dual therapy matched the efficacy of conventional BQT in treatment-naïve patients, supporting its potential role as a streamlined first-line strategy for H. pylori eradication while reducing treatment complexity.
European Journal of Gastroenterology & Hepatology
Efficacy and safety of tegoprazan–amoxicillin dual therapy versus bismuth-containing quadruple therapy for first-line Helicobacter pylori eradication: a systematic review and meta-analysis of randomized controlled trials
Jin Ho Hwang et al.
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