Vonoprazan vs. Proton Pump Inhibitors for Treatment and Prevention of Gastric and/or Duodenal Ulcers: A Systematic Review with Meta-Analysis.
Meta-analysis
Peptic ulcer
Post-ESD ulcers
Proton pump inhibitor
Vonoprazan
Journal
Digestive diseases and sciences
ISSN: 1573-2568
Titre abrégé: Dig Dis Sci
Pays: United States
ID NLM: 7902782
Informations de publication
Date de publication:
18 Sep 2024
18 Sep 2024
Historique:
received:
06
04
2024
accepted:
10
08
2024
medline:
19
9
2024
pubmed:
19
9
2024
entrez:
18
9
2024
Statut:
aheadofprint
Résumé
Although Vonoprazan, a potassium-competitive acid blocker, is superior to proton pump inhibitors (PPIs) in treating Helicobacter pylori and erosive esophagitis, its efficacy for treating gastric and/or duodenal ulcers remains controversial. This meta-analysis summarizes the efficacy and safety of Vonoprazan vs. PPI for treating and preventing gastric and/or duodenal ulcers. Only randomized controlled trials randomizing gastric and/or duodenal ulcer patients, regardless of etiology, into Vonoprazan or any PPI and indexed in Embase, Medline, and CENTRAL until March 2, 2024 were searched. Primary outcomes were ulcer healing rates at Weeks 2, 4, 6, and 8 and recurrence rates at Week 24. Other outcomes included shrinkage rates, any adverse events (AEs), serious AEs (SAEs), and risks of delayed bleeding and perforation. The overall risk ratio (RR) and mean difference were pooled using the random-effects model. The risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB2) Tool. Fifteen studies comprising 43 reports were included in the analysis. Healing rates of gastric and/or duodenal ulcers were similar in both Vonoprazan and PPI groups at all weeks (Week 2 RR 1.02 [95% CI 0.89-1.16]; Week 4 0.99 [95% CI 0.95-1.04]; Week 6 1.00 [95% CI 0.96-1.03]; Week 8 0.99 [95% CI 0.95-1.03]). The recurrence prevention of peptic ulcers was not different in Vonoprazan 10 mg (RR 0.48; 95% CI 0.18-1.27) or 20 mg (0.60; 95% CI 0.28-1.30) to PPI. Shrinkage rates, any AEs, SAEs, and risks of delayed bleeding and perforation were similar in both groups. Vonoprazan is not significantly better than PPI in treating and preventing gastric and/or duodenal ulcers.
Identifiants
pubmed: 39294424
doi: 10.1007/s10620-024-08593-5
pii: 10.1007/s10620-024-08593-5
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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