Efficacy and safety of potassium-competitive acid blockers in eradicating Helicobacter pylori and treating gastro-esophageal reflux disease: A systematic review and meta-analysis
Abstract
Background: This systematic review aimed to assess the efficacy and safety of PCAB versus PPI in eradicating H. pylori and GERD.
Methods: The studies were searched through databases of PubMed, ScienceDirect, Wiley Online Library, and CENTRAL. A random-effects meta-analysis was performed to evaluate the efficacy and safety of PCAB in eradicating H. pylori and treating GERD, using odds ratios (OR) and 95% confidence intervals (95%CI) as the effect measures.
Results: PCAB therapy demonstrated superior efficacy and safety compared to PPI-based therapy in eradicating H. pylori (efficacy OR 1.40 [95% CI 1.12-1.76]; safety OR 0.71 [0.52-0.95]) and treating GERD (efficacy OR 1.62 [1.01-2.61]; safety OR 0.90 [0.71-1.14]). Vonoprazan therapy, but not tegoprazan, particularly showed superiority, with ORs of 1.66 [1.24-2.23] for H. pylori eradication (safety OR 0.71 [0.52-0.95]) and 1.80 [1.00-3.25] for GERD (safety OR 1.03 [0.83-1.27]). For H. pylori eradication, vonoprazan triple therapy showed greater efficacy overall (OR 1.94 [1.19-3.17]) and compared to lansoprazole (OR 2.84 [1.97-4.11]) and rabeprazole (OR 2.63 [1.05-6.58]), though not compared to esomeprazole (OR 1.62 [0.69-3.81]). In GERD treatment, both short-term (8 weeks) and long-term (24 weeks) vonoprazan therapies were similarly effective (OR 2.55 [1.71-3.80] and OR 2.17 [1.00-4.72], respectively) and showed particular efficacy in patients with severe (grade C/D) reflux esophagitis (OR 3.51 [1.65-7.46]).
Conclusions:…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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