Network Meta-Analysis of Comparing Different Dosages of Potassium-Competitive Acid Blocker With Proton-Pump Inhibitor in Acid-Related Disorders.

IF 3 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Clinical and Translational Gastroenterology Pub Date : 2024-10-16 DOI:10.14309/ctg.0000000000000776

Yujiao Wang, Xiaosong Dai, Xinxing Zhang

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Abstract

Introduction: Potassium-competitive acid blockers have emerged as a promising treatment of acid-related disorders. However, the optimal dosage for maximizing their efficacy remains unclear. The aim of this network meta-analysis was to compare the efficacy and safety of various dosages of potassium-competitive acid blockers and proton-pump inhibitors for treating acid-related disorders.

Methods: We searched PubMed, Embase, Cochrane Library, and Web of Science from inception to July 16, 2023. Data extraction was performed independently by 2 authors. The Cochrane Risk of Bias in Randomized Trials tool (RoB 2.0) was used for bias assessment. The efficacy and safety were compared using the odds ratio with 95% confidence intervals.

Results: Twelve articles were included in the present meta-analysis. For gastric/duodenal ulcers, keverprazan 30 mg (K30) exhibited the highest surface under the cumulative ranking (SUCRA) value (92.8%) for healing rate. In terms of total adverse events, lansoprazole 30 mg (L30) exhibited the lowest SUCRA value (25.3%) in the treatment of gastric/duodenal ulcers. For the healing rate in erosive esophagitis, the maximum SUCRA value of vonoprazan 40 mg (V40) was 90.7% in the first subgroup (erosive esophagitis using vonoprazan, keverprazan, and lansoprazole) and the maximum SUCRA value of T50 was 72.1% in the second subgroup (erosive esophagitis using tegoprazan, fexuprazan, and esomeprazole). For the total adverse events in erosive esophagitis, L15 exhibited the lowest SUCRA value (12.2%) in the first group and E40 exhibited the lowest SUCRA value (24.4%) in the second group.

Discussion: K30 may be the most effective dosage for increasing the healing rate of gastric/duodenal ulcers. For erosive esophagitis, V40 and T50 may be the preferred dosages.

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比较不同剂量的钾竞争性酸阻滞剂和质子泵抑制剂治疗酸相关疾病的网络荟萃分析。

背景：钾竞争性酸阻滞剂（P-CABs）已成为治疗酸相关性疾病（ARDs）的一种很有前景的方法。然而，最大限度发挥其疗效的最佳剂量仍不明确。本网络荟萃分析旨在比较不同剂量的P-CABs和质子泵抑制剂（PPIs）治疗ARDs的疗效和安全性：我们检索了从开始到 2023 年 7 月 16 日的 PubMed、EMBASE、Cochrane Library 和 Web of Science。数据提取由两位作者独立完成。偏倚评估采用 Cochrane 随机试验偏倚风险工具（RoB 2.0）。疗效和安全性的比较采用几率比（OR）和 95% 置信区间（CI）：本荟萃分析共纳入 12 篇文章。对于胃/十二指肠溃疡，开维普拉赞 30 毫克（K30）的愈合率 SUCRA 值最高（92.8%）。在不良反应方面，兰索拉唑 30 毫克（L30）治疗胃/十二指肠溃疡的 SUCRA 值最低（25.3%）。关于侵蚀性食管炎的愈合率，在第一分组（使用冯诺普拉赞、凯弗拉赞和兰索拉唑治疗侵蚀性食管炎）中，冯诺普拉赞 40 毫克（V40）的最高 SUCRA 值为 90.7%，在第二分组（使用替戈普拉赞、非昔普拉赞和艾索美拉唑治疗侵蚀性食管炎）中，T50 的最高 SUCRA 值为 72.1%。在侵蚀性食管炎的不良反应方面，第一组中 L15 的 SUCRA 值最低（12.2%），第二组中 E40 的 SUCRA 值最低（24.4%）：结论：K30可能是提高胃/十二指肠溃疡愈合率的最有效剂量。结论：K30可能是提高胃/十二指肠溃疡愈合率的最有效剂量，对于侵蚀性食管炎，V40和T50可能是首选剂量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Translational Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

7.00

自引率

0.00%

发文量

114

审稿时长

16 weeks

期刊介绍： Clinical and Translational Gastroenterology (CTG), published on behalf of the American College of Gastroenterology (ACG), is a peer-reviewed open access online journal dedicated to innovative clinical work in the field of gastroenterology and hepatology. CTG hopes to fulfill an unmet need for clinicians and scientists by welcoming novel cohort studies, early-phase clinical trials, qualitative and quantitative epidemiologic research, hypothesis-generating research, studies of novel mechanisms and methodologies including public health interventions, and integration of approaches across organs and disciplines. CTG also welcomes hypothesis-generating small studies, methods papers, and translational research with clear applications to human physiology or disease. Colon and small bowel Endoscopy and novel diagnostics Esophagus Functional GI disorders Immunology of the GI tract Microbiology of the GI tract Inflammatory bowel disease Pancreas and biliary tract Liver Pathology Pediatrics Preventative medicine Nutrition/obesity Stomach.