Lancet Infect Dis

Triple therapy including novel agent noninferior to standard regimen in H. pylori eradication

September 15, 2025

Study details: EVEREST-HP was a phase 3, multicentre, randomized, triple-dummy, double-blind, controlled, non-inferiority trial conducted across 40 hospitals in China. It compared a 14-day rifasutenizol-based triple therapy (rifasutenizol, amoxicillin, rabeprazole) with a bismuth-containing quadruple therapy (BQT: bismuth, clarithromycin, amoxicillin, rabeprazole) in 700 treatment-naive adults with confirmed H. pylori infection. Primary endpoint was eradication assessed via ¹³C-urea breath test 4 to 6 weeks post-treatment.

Results: Rifasutenizol therapy achieved higher eradication rates than BQT in the modified intention-to-treat population (92.0% vs. 87.9%). Notably, rifasutenizol retained efficacy in patients with antibiotic-resistant H. pylori strains. Safety outcomes favored rifasutenizol, with fewer treatment-emergent adverse events and no serious drug-related events.

Clinical impact: Rifasutenizol-based triple therapy offers a promising, well-tolerated alternative to current first-line regimens, particularly in regions with high clarithromycin resistance. Its broad activity and favorable safety profile support its potential as a new standard for H. pylori eradication in China and beyond.

Source:

Song Z, et al. (2025, September 10). Lancet Infect Dis. Rifasutenizol-based triple therapy versus bismuth plus clarithromycin-based triple therapy for first-line treatment of Helicobacter pylori infection in China (EVEREST-HP): a phase 3, multicentre, randomised, triple-dummy, double-blind, controlled, non-inferiority trial. https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(25)00438-4/abstract