A new treatment for the world's most common infection

Are you prone to symptoms like abdominal or ‘stomach’ pain, frequent burping or bloating? You might be experiencing the effects of being infected with H. pylori. — 123rf.com

What do you think is the most common infectious disease in the world? It’s a good bet that many people would not suspect the stomach disorder caused by Helicobacter pylori, which affects half of the world’s population.

Infected individuals can be completely asymptomatic or suffer from common symptoms like abdominal pain, nausea, loss of appetite, frequent burping, bloating and unintentional weight loss.

While the exact mode of transmission remains unknown, H. pylori may spread from person to person through saliva, vomit or faecal matter. This bacteria has been identified as one of the main causes for peptic ulcer disease and gastric cancers worldwide.

In 2012, H. pylori infections were estimated as the cause of approximately 774,000 new cases of gastric cancer globally.

Meanwhile, erosive oesophagitis refers to the inflammation of the oesophagus due to reflux of acidic contents from the stomach back into the oesophagus. It is characterised by symptoms such as difficult or painful swallowing, chest pain associated with meals, heartburn and a feeling of food being stuck in the throat.

In a study conducted at Hospital Kuala Lumpur, as much as 13% of patients undergoing upper gastrointestinal endoscopic examination had endoscopic evidence of erosive oesophagitis.

Says Emeritus Professor Datuk Dr Goh Khean Lee from Universiti Malaya: “H. pylori has always been an infection that is overlooked due to its commonality. What most people are unaware of is that the International Agency for the Research of Cancer (IARC) and the World Health Organisation (WHO) have classified H. pylori as a group 1 carcinogen, which is in the same group as tobacco smoking.

“Hence, we need to start prioritising eradication of the infection, as opposed to just treating the gastric symptoms with over-the-counter medications.”

He adds: “For over 20 years, the first-line therapy for H. pylori infections have been a combination of proton-pump inhibitors (PPIs) and antibiotics. But we have seen a dramatic shift in its efficacy with eradication rates falling below 80% in many countries, and reaching less than 70% in some regions. We need to start looking at other treatment options to combat this infection.”

One of the most effective ways to overcome bacterial resistance to antibiotics is to ensure potent and sustained acid suppression.

Potent acid suppression enhances the action of concomitantly-prescribed antibiotics such as amoxicillin and clarithromycin, resulting in excellent eradication rates of H. pylori over a short period of treatment.

This can be accomplished by using Vocinti, also known by its generic name vonoprazan, which was launched in Malaysia on Aug 16, 2019. Vocinti is a potassium-competitive acid blocker with a high affinity for acid pumps in the stomach, which inhibits the production of gastric acid in the stomach.

Explains Japan’s Juntendo University Department of Gastroenterology professor Dr Akihito Nagahara: “Vocinti not only reduces acid secretion rapidly from the very first dose, but also provides a consistent and durable mode of action.

“Not only does Vocinti ensure the high efficacy of H. pylori eradication therapy, it also results in faster healing of erosive oesophagitis and relief of symptoms. Furthermore, it also addresses the crucial issue of nocturnal acid breakthrough,”

A six-week study showed that Vocinti is as well tolerated as PPIs in the treatment of H. pylori infections and erosive oesophagitis.

Says Takeda Malaysia, Singapore, Vietnam and Philippines Cluster head Michelle Erwee: “We are excited to be bringing Vocinti to Malaysian shores. We have seen great success in treating H. pylori infections and erosive oesophagitis in Japan and are confident that we will be able to replicate that here as well.

“Vocinti offers a rapid onset of action, along with strong and sustained suppression of gastric acid, in a convenient dosing schedule for patients.”

She adds: “H. pylori infections and erosive oesophagitis affect many people in Malaysia. Addressing such prevalent diseases is always a challenge, but we cannot look away when the lives of so many are affected on a daily basis.

“Vocinti is more than just a drug to us, it is a representation of our commitment to continue improving the lives of Malaysians suffering from the effects of chronic gastrointestinal discomfort.”

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