S561 Vonoprazan Is Superior to a Proton Pump Inhibitor in Healing Severe Erosive Esophagitis: A Meta-Analysis of Randomized Controlled Trials
Abstract
Introduction: Although Proton Pump Inhibitor (PPI) is the therapy of choice for the healing of Erosive Esophagitis (EE), healing rates for patients with severe EE (Los Angeles [LA] Grade C/D) is suboptimal (∼60-70%). Vonoprazan, a new acid-suppressive drug in the Potassium Competitive Acid Blocker class, is suggested to have better efficacy in healing EE, especially for those with severe esophagitis. This meta-analysis compares the efficacy and safety of Vonoprazan 20mg to PPI for healing EE, especially in those with LA Grade C/D. Methods: We searched MEDLINE, Embase, and Central for studies published from database inception to May 24, 2023. Randomized Controlled Trials (RCTs), which randomized patients with EE to Vonoprazan 20mg or a PPI and compared the healing rates, were included in this meta-analysis. The risk of bias was assessed using Cochrane’s Risk of Bias 2 (RoB2) tool. The fixed-effect model was used to obtain the pooled efficacy and safety outcomes of Vonoprazan 20mg compared to PPI. Subgroup analysis was done to compare healing rates in patients with mild EE (LA Grade A/B) and severe EE. Results: Overall, 4 RCTs with low risks of bias comprising 2208 participants were included. Lansoprazole 30mg was the only PPI used as the comparator in all included studies. As compared to Lansoprazole 30mg, Vonoprazan demonstrated superior healing rates in Weeks 2 (RR 1.092 [95% CI 1.041-1.145]; study n = 4) and 8 (RR 1.057 [95% CI 1.029-1.087]; study n = 4), but not in Week 4…
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: 2,208 participants or records.
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