The Efficacy of Keveprazan, Vonoprazan, and Lansoprazole for the Treatment of Gastroesophageal Reflux Disease: A Network Meta-Analysis
Abstract
BACKGROUND
Novel potassium-competitive acid blockers (P-CABs) are recognized to have more potent acid-suppressive efficacy than proton pump inhibitors (PPIs). This study comprehensively summarizes the clinical evidence regarding P-CABs in patients with gastrooesophageal reflux disease (GERD), with a particular focus on erosive oesophagitis (EO).
METHODS
A network meta-analysis was carried out by retrieving randomized controlled trials of P-CABs and PPIs for the management of EO patients from PubMed, Embase, and CENTRAL between January 1st, 1990, and November 19th, 2022. The selected participants received oral treatment with 20 mg keveprazan (KPZ), 10-40 mg vonoprazan (VPZ), or 30 mg lansoprazole (LPZ), once daily for 2-8 weeks. We compared the efficacy and safety of KPZ, VPZ, and LPZ at different doses and follow-up time points in EO patients.
RESULTS AND DISCUSSIONS
From 183 initially identified citations, six eligible studies were included, encompassing 2,864 participants. Robust evidence indicated that 20 mg VPZ was superior to 30 mg LPZ in achieving EO healing at the 2-week follow-up. Furthermore, 40 mg VPZ demonstrated greater efficacy than 5 mg VPZ. Both 20 mg VPZ and 30 mg LPZ were less effective in patients with severe reflux disease (LA classification C/D) than in those with mild disease (A/B). Additionally, 20 mg VPZ was more effective than 30 mg LPZ in reducing serum gastrin and pepsinogen I levels after 4 weeks of intervention. Notably, 20 mg KPZ was associated…
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: 2,864 participants or records.
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