Efficacy and Safety of Tegoprazan in Helicobacter pylori Eradication: An Umbrella Review of Meta-Analyses
Abstract
Objective: This umbrella review synthesizes and critically appraises the evidence on the efficacy and safety of tegoprazan-based versus proton pump inhibitor (PPI)-based regimens for Helicobacter pylori (H. pylori) eradication. Methods: This umbrella review was pre-registered in PROSPERO (CRD420251271120). Systematic reviews and meta-analyses published between 1 January 2018 and 10 December 2025 were identified through MEDLINE/PubMed, EMBASE, and the Cochrane Library. Reviews comparing tegoprazan-based and PPI-based eradication regimens in adult patients were included. Methodological quality was assessed using AMSTAR-2, risk of bias with ROBIS, and certainty of evidence with GRADE. Pooled relative risks (RRs) were calculated, with subgroup analyses by study design, treatment duration, and therapeutic regimen. Results: Eight systematic reviews and meta-analyses encompassing 17 primary studies and 12,714 participants were included. Tegoprazan-based regimens were associated with a statistically significant improvement in eradication efficacy compared with PPI-based therapies (RR = 1.019; 95% CI: 1.003-1.035; p = 0.021). In randomized controlled trials, the benefit was more pronounced (RR = 1.037; 95% CI: 1.015-1.061; p = 0.001), whereas no statistically significant benefit was observed in non-randomized studies (RR = 1.014; 95% CI: 0.991-1.037; p = 0.235). The efficacy advantage was mainly confined to quadruple therapy regimens (RR = 1.044; 95% CI: 1.002-1.088; p = 0.038).…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 12,714 participants or records.
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