Comparative efficiency and safety of potassium competitive acid blockers <i>versus</i> Lansoprazole in peptic ulcer: a systematic review and meta-analysis

作者全名："Dong, Yongqi; Xu, Hongyan; Zhang, Zhihuan; Zhou, Zhihang; Zhang, Qiang"

作者地址："[Dong, Yongqi] Wushan Cty Peoples Hosp Chongqing, Dept Gastroenterol, Chongqing, Peoples R China; [Xu, Hongyan] Chongqing Med Univ, Affiliated Hosp 2, Dept Infect Dis, Chongqing, Peoples R China; [Zhang, Zhihuan] Chongqing Med Univ, Affiliated Hosp 2, Dept Rheumatol & Immunol, Chongqing 400010, Peoples R China; [Zhou, Zhihang] Chongqing Med Univ, Affiliated Hosp 2, Dept Gastroenterol, Chongqing 400010, Peoples R China; [Zhang, Qiang] Wushan Cty Peoples Hosp Chongqing, Dept Spinal Surg, Chongqing, Peoples R China"

通信作者："Zhang, Q (通讯作者)，Wushan Cty Peoples Hosp Chongqing, Dept Spinal Surg, Chongqing, Peoples R China."

来源：FRONTIERS IN PHARMACOLOGY

ESI学科分类：PHARMACOLOGY & TOXICOLOGY

WOS号：WOS:001149005600001

JCR分区：Q1

影响因子：5.6

年份：2024

卷号：14

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：potassium competitive acid blocker; lansoprazole; peptic ulcer; vonoprazan; tegoprazan; keverprazan

摘要："Background: Lansoprazole, a proton-pump inhibitor (PPI), is the primary therapy for peptic ulcers (PU). Potassium competitive acid blockers (P-CAB) offer an alternative for acid suppression. However, the efficacy and safety of P-CABs versus lansoprazole in the management of PU has not been evaluated. Methods: Five databases were searched for randomized clinical trials in English until 31 August 2023. Data extraction provided outcome counts for ulcer healing, recurrent NSAID-related ulcer, and adverse events. The pooled effect, presented as rate difference (RD), was stratified by ulcer location, follow-up time, and the types of P-CAB, along with their corresponding 95% confidence intervals (95% CI). Results: The pooled healing rates of peptic ulcers were 95.3% (1,100/1,154) and 95.0% (945/995) for P-CABs and lansoprazole, respectively (RD: 0.4%, 95% CI: -1.4%-2.3%). The lower bounds of the 95% CI fell within the predefined non-inferiority margin of -6%. In subgroup analyses base on ulcer location, and follow-up time also demonstrated non-inferiority. The drug-related treatment-emergent adverse events (TEAEs) did not differ significantly among groups (RR: 0.997, 95% CI: 0.949-1.046, p = 0.893). However, P-CAB treatment was associated with an increased risk of the serious adverse events compared to lansoprazole (RR: 1.325, 95% CI: 1.005-1.747, p = 0.046). Conclusion: P-CABs demonstrated non-inferiority to lansoprazole in the management of peptic ulcer. The safety and tolerability profile are comparable, with similar TEAEs rates. However, P-CABs appear to have a higher risk of serious adverse events. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=458361 Identifier: PROSPERO (No. CRD42023458361)."

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