Vonoprazan in the management of gastric/peptic ulcers: a systematic review of safety data

Moraes-Filho, Joaquim Prado P; Domingues, Gerson; Chinzon, Décio; Guedes, Juliana Leite Soares; Santos, Cláudia Y.; Zaterka, Schlioma

doi:10.5114/pg.2022.112777

Cited by 4 publications

(3 citation statements)

References 21 publications

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“…Systematic analyses have shown comparable rate of treatment emergent adverse events (TEAEs) between PCABs and PPIs in RCTs [21 ▪ ,43]. In one systematic analysis, the most common TEAE for vonoprazan was nasopharyngitis, followed by diarrhea [43]. Generally, vonoprazan was well tolerated.…”

Section: Safety and Adverse Eventsmentioning

confidence: 99%

Potassium-competitive acid blockers and acid-related disorders

Huang,

Weber

2024

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

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Purpose of the review Potassium-competitive acid blockers (PCABs) represent a new class of compounds for the treatment of acid-related disorders. Recent FDA approval of the PCAB vonoprazan for erosive esophagitis has started an important new approach to acid-related disorders. Recent findings Compared to conventional proton pump inhibitors (PPIs), PCABs provide more rapid, potent, and sustained suppression of gastric acid with faster and more durable symptom relief. Studies have demonstrated the efficacy of PCABs for erosive esophagitis, nonerosive reflux disease, and peptic ulcer disease including H. pylori. However, the PCAB vonoprazan was only approved in the US as part of combination therapy for eradication of H. pylori. Clinical trials have now demonstrated noninferiority of vonoprazan to lansoprazole for treatment of erosive esophagitis, particularly noting superiority of vonoprazan in patients with severe esophagitis resulting in FDA approval of vonoprazan for treatment of erosive esophagitis. Emerging data suggests a possible utility of vonoprazan for PPI-resistant gastroesophageal reflux disease (GERD) and on-demand therapy for nonerosive reflux disease. Vonoprazan is generally well tolerated but long-term safety data is not well established. Summary The PCAB vonoprazan is a newly FDA approved treatment option for erosive esophagitis. Its possible role in PPI-resistant GERD and nonerosive reflux disease warrants further investigation.

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Section: Safety and Adverse Eventsmentioning

confidence: 99%

Potassium-competitive acid blockers and acid-related disorders

Huang,

Weber

2024

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

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“…VPZ, a publicly available drug, is widely used in treating acidrelated disorders, 33,37,38 thus, the benefits of VPZ-based regimens are documented in this meta-analysis, notwithstanding some limitations. First, all included studies were performed in China, and regional differences in diets and genetic factors can affect gastric pH.…”

Section: Different First-line Treatments Including Ppi-containing Triplementioning

confidence: 99%

Meta‐analysis of Helicobacter pylori eradication therapy using vonoprazan as an acid suppressor compared with bismuth quadruple therapy

Yang,

Zhang,

et al. 2024

Helicobacter

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BackgroundVonoprazan, a novel acid suppressant, has recently emerged as a regimen for eradicating Helicobacter pylori. However, uncertainties exist about the effectiveness and safety of VPZ‐based regimens compared with those of bismuth‐based quadruple therapy in eradicating H. pylori. The present meta‐analysis was performed to compare the effectiveness and safety of vonoprazan‐based regimens with those of bismuth quadruple therapy in eradicating H. pylori.Materials and MethodsAll randomized controlled trials and non‐randomized controlled trials comparing the vonoprazan‐based therapy with the bismuth quadruple therapy were included in this meta‐analysis. Information was also extracted by two evaluators, and if heterogeneity existed, a random‐effects model was used to calculate the combined relative ratio and 95% confidence interval; otherwise, a fixed‐effects model was used. And subgroup analyses were performed to explore the sources of heterogeneity.ResultsA total of 10 studies, comprising 2587 patients were included in the meta‐analysis. The results showed that the combined eradication rate of patients treated with the vonoprazan‐based regimen was significantly higher than that of patients treated with bismuth quadruple therapy, in both intention‐to‐treat and per‐protocol analyses, and the differences were statistically significant. Among the intention‐to‐treat analyses results: (90.28% vs. 83.64% [odds ratio (OR) = 1.85, 95% confidence interval (CI) (1.27, 2.70), p = 0.001]); in the per‐protocol analyses: (94.80% vs. 89.88%, [OR = 2.25, 95% CI (1.37, 3.69), p = 0.001]). The occurrence of adverse events was significantly lower in patients treated with vonoprazan‐based regimens than in those treated with bismuth quadruple therapy, (14.50% vs. 25.89%, [OR = 0.49, 95% CI (0.32, 0.75), p = 0.001]).ConclusionsFor eradicating H. pylori, vonoprazan‐based regimens are remarkably advantageous over bismuth quadruple therapy. Furthermore, vonoprazan‐based regimens exhibit a lower rate of adverse events than bismuth quadruple therapy.

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“…Большинство этих осложнений (суммарно -порядка 5%), классифицировались как легкие [35]. В недавнем систематическом обзоре, целенаправленно посвященном вопросу безопасности В, включившем 10 исследований с 4100 участниками [36], также отмечен в целом её благоприятный профиль в случаях лечения эрозивного эзофагита, пептической язвы желудка либо ДПК, а также НПВС-ассоциированных повреждений желудка. В использовался как для стартовой, так и для поддерживающей терапии.…”

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Competitive proton pump inhibitors - status and Prospects of use

Ортенберг

Lyapina

Dorodneva

2023

jour

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Purpose. To summarize the estimates of the effect of the use of potassium-competitive proton pump inhibitors in pharmacotherapy algorithms for patients with peptic ulcer disease, GERD on treatment outcomes. Material and methods. The most large-scale (as a rule) publications of the last five years devoted to the problem under consideration are analyzed. The search was carried out by keywords in the Pubmed information database (ncbi.nlm.nih.gov). Findings. Potassium-competitive acid blockers (P-CABs), in comparison with «traditional» drugs of this class (proton pump inhibitors), have advantages from a clinical and pharmacoeconomic point of view both in peptic ulcer disease (in particular, as part of eradication therapy) and in gastro-esophageal reflux disease. Confirmation of these data in the conditions of use of K-CCB in patients of the Russian Federation seems appropriate.

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Vonoprazan in the management of gastric/peptic ulcers: a systematic review of safety data

Cited by 4 publications

References 21 publications

Potassium-competitive acid blockers and acid-related disorders

Potassium-competitive acid blockers and acid-related disorders

Meta‐analysis of Helicobacter pylori eradication therapy using vonoprazan as an acid suppressor compared with bismuth quadruple therapy

Competitive proton pump inhibitors - status and Prospects of use

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