S2118 Seven-Day Tegoprazan Therapy Matches Proton Pump Inhibitors and 14-Day Therapies for H. pylor Eradication With Much Fewer Adverse Events: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Abstract
Introduction: Despite guideline-mandated 14-day quadruple therapy, real-world eradication of Helicobacter pylori continues to falter because proton-pump inhibitors (PPIs) give slow, CYP2C19-dependent acid control and carry growing clarithromycin resistance. Potassium-competitive acid blockers such as tegoprazan achieve near-instant, sustained pH > 6 and have delivered non-inferior or superior cure rates in trials while shortening therapy duration and mitigating dyspepsia-related toxicity. Whether a 7-day tegoprazan-based course can match conventional PPI or longer tegoprazan regimens and simultaneously improve tolerability remains a clinically pivotal question for stewardship. Methods: A systematic search of PubMed, Embase, Scopus, and Cochrane Library identified Randomized Controlled Trials (RCTs) comparing 7-day tegoprazan Therapy versus PPIs or 14-day regimens for H. pylori eradication through May 2025. Data were analyzed using RevMan 4.2.1. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using Mantel-Haenszel methods. Random- or fixed-effects models were applied based on heterogeneity (Higgins’ I²). Statistical significance was set at P < 0.05. Risk of bias was assessed using RoB 2.0. Results: Four RCTs (n = 1,668; 7-day tegoprazan = 841, control = 827) showed identical eradication efficacy confirmed by urea breath test (RR 0.99, 95% CI 0.94-1.04; I² = 0%) with the abbreviated tegoprazan regimen. Serious adverse events (SAEs) fell by 40% (RR…
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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: 1,668 participants or records.
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