TY - JOUR
T1 - Vonoprazan vs. Proton Pump Inhibitors for Treatment and Prevention of Gastric and/or Duodenal Ulcers
T2 - A Systematic Review with Meta-Analysis
AU - Simadibrata, Daniel Martin
AU - Lesmana, Elvira
AU - Pratama, Muhammad Iqbal Adi
AU - Sugiharta, Adrianus Jonathan
AU - Kalaij, Ayers Gilberth Ivano
AU - Fadhilla, Arzita Diandra Diva
AU - Danpanichkul, Pojsakorn
AU - Syam, Ari Fahrial
AU - Simadibrata, Marcellus
N1 - Publisher Copyright:
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024.
PY - 2024/10
Y1 - 2024/10
N2 - Introduction: Although Vonoprazan, a potassium-competitive acid blocker, is superior to proton pump inhibitors (PPIs) in treating Helicobacter pylori and erosive esophagitis, its efficacy for treating gastric and/or duodenal ulcers remains controversial. This meta-analysis summarizes the efficacy and safety of Vonoprazan vs. PPI for treating and preventing gastric and/or duodenal ulcers. Methods: Only randomized controlled trials randomizing gastric and/or duodenal ulcer patients, regardless of etiology, into Vonoprazan or any PPI and indexed in Embase, Medline, and CENTRAL until March 2, 2024 were searched. Primary outcomes were ulcer healing rates at Weeks 2, 4, 6, and 8 and recurrence rates at Week 24. Other outcomes included shrinkage rates, any adverse events (AEs), serious AEs (SAEs), and risks of delayed bleeding and perforation. The overall risk ratio (RR) and mean difference were pooled using the random-effects model. The risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB2) Tool. Results: Fifteen studies comprising 43 reports were included in the analysis. Healing rates of gastric and/or duodenal ulcers were similar in both Vonoprazan and PPI groups at all weeks (Week 2 RR 1.02 [95% CI 0.89–1.16]; Week 4 0.99 [95% CI 0.95–1.04]; Week 6 1.00 [95% CI 0.96–1.03]; Week 8 0.99 [95% CI 0.95–1.03]). The recurrence prevention of peptic ulcers was not different in Vonoprazan 10 mg (RR 0.48; 95% CI 0.18–1.27) or 20 mg (0.60; 95% CI 0.28–1.30) to PPI. Shrinkage rates, any AEs, SAEs, and risks of delayed bleeding and perforation were similar in both groups. Conclusion: Vonoprazan is not significantly better than PPI in treating and preventing gastric and/or duodenal ulcers.
AB - Introduction: Although Vonoprazan, a potassium-competitive acid blocker, is superior to proton pump inhibitors (PPIs) in treating Helicobacter pylori and erosive esophagitis, its efficacy for treating gastric and/or duodenal ulcers remains controversial. This meta-analysis summarizes the efficacy and safety of Vonoprazan vs. PPI for treating and preventing gastric and/or duodenal ulcers. Methods: Only randomized controlled trials randomizing gastric and/or duodenal ulcer patients, regardless of etiology, into Vonoprazan or any PPI and indexed in Embase, Medline, and CENTRAL until March 2, 2024 were searched. Primary outcomes were ulcer healing rates at Weeks 2, 4, 6, and 8 and recurrence rates at Week 24. Other outcomes included shrinkage rates, any adverse events (AEs), serious AEs (SAEs), and risks of delayed bleeding and perforation. The overall risk ratio (RR) and mean difference were pooled using the random-effects model. The risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB2) Tool. Results: Fifteen studies comprising 43 reports were included in the analysis. Healing rates of gastric and/or duodenal ulcers were similar in both Vonoprazan and PPI groups at all weeks (Week 2 RR 1.02 [95% CI 0.89–1.16]; Week 4 0.99 [95% CI 0.95–1.04]; Week 6 1.00 [95% CI 0.96–1.03]; Week 8 0.99 [95% CI 0.95–1.03]). The recurrence prevention of peptic ulcers was not different in Vonoprazan 10 mg (RR 0.48; 95% CI 0.18–1.27) or 20 mg (0.60; 95% CI 0.28–1.30) to PPI. Shrinkage rates, any AEs, SAEs, and risks of delayed bleeding and perforation were similar in both groups. Conclusion: Vonoprazan is not significantly better than PPI in treating and preventing gastric and/or duodenal ulcers.
KW - Meta-analysis
KW - Peptic ulcer
KW - Post-ESD ulcers
KW - Proton pump inhibitor
KW - Vonoprazan
UR - http://www.scopus.com/inward/record.url?scp=85204187515&partnerID=8YFLogxK
U2 - 10.1007/s10620-024-08593-5
DO - 10.1007/s10620-024-08593-5
M3 - Article
C2 - 39294424
AN - SCOPUS:85204187515
SN - 0163-2116
VL - 69
SP - 3863
EP - 3874
JO - Digestive Diseases and Sciences
JF - Digestive Diseases and Sciences
IS - 10
ER -