Vonoprazan vs. Proton Pump Inhibitors for Treatment and Prevention of Gastric and/or Duodenal Ulcers: A Systematic Review with Meta-Analysis
- 18.09.2024
- Original Article
Erschienen in:
- Verfasst von
- Daniel Martin Simadibrata
- Elvira Lesmana
- Muhammad Iqbal Adi Pratama
- Adrianus Jonathan Sugiharta
- Ayers Gilberth Ivano Kalaij
- Arzita Diandra Diva Fadhilla
- Pojsakorn Danpanichkul
- Ari Fahrial Syam
- Marcellus Simadibrata
- Erschienen in
- Digestive Diseases and Sciences | Ausgabe 10/2024
Abstract
Introduction
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.
Methods
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.
Results
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.
Conclusion
Vonoprazan is not significantly better than PPI in treating and preventing gastric and/or duodenal ulcers.
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- Titel
- Vonoprazan vs. Proton Pump Inhibitors for Treatment and Prevention of Gastric and/or Duodenal Ulcers: A Systematic Review with Meta-Analysis
- Verfasst von
-
Daniel Martin Simadibrata
Elvira Lesmana
Muhammad Iqbal Adi Pratama
Adrianus Jonathan Sugiharta
Ayers Gilberth Ivano Kalaij
Arzita Diandra Diva Fadhilla
Pojsakorn Danpanichkul
Ari Fahrial Syam
Marcellus Simadibrata
- Publikationsdatum
- 18.09.2024
- Verlag
- Springer US
- Erschienen in
-
Digestive Diseases and Sciences / Ausgabe 10/2024
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568 - DOI
- https://doi.org/10.1007/s10620-024-08593-5
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