Vonoprazan non‐inferior to lansoprazole in treating duodenal ulcer and eradicating <scp><i>Helicobacter pylori</i></scp> in Asian patients

Hou, Xiaohua; Meng, Fandong; Wang, Jiangbin; Sha, Weihong; Chiu, Cheng‐Tang; Chung, Woo Chul; Gu, Liqun; Kudou, Kentarou; Chong, Chui Fung; Zhang, Shutian

doi:10.1111/jgh.15837

Cited by 38 publications

(39 citation statements)

References 39 publications

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“…Vonoprazan was similar to PPIs (7-VAC and 14-OAC groups: 96.7% and 88.5%, p=0.083, respectively) in the analysis with the intention-to-treat and 98.3% and 93.1%, p=0.159, respectively, in the per protocol). Hou et al 36 Furthermore, the results of the per-protocol analysis were comparable to those of the intention-to-treat analysis (89.3% vs. 90.1%, P=0.06).…”

Section: Primary-line Treatmentmentioning

confidence: 72%

Vonoprazan: A systematic review of an alternative to proton pump inhibitors

Silva¹,

Figueiredo²,

Gonçalves³

et al. 2022

GHOA

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Vonoprazan is a novel potassium-competitive acid blocker (P-CAB) that works through a reversible potassium-specific competitive mechanism to inhibit active proton pumps directly. In contrast to standard proton pump inhibitors, vonoprazan does not require acid activation or any time constraints for its administration. As a result of its rapid onset and prolonged action, vonoprazan is a suitable option for PPI. In this study, we compare the efficacy of vonoprazan and PPIs in treating Gastroesophageal Reflux Disease (GERD), H. pylori, and post-endoscopic submucosal dissection (ESD) bleeding and ulcers. A PRISMA-guided systematic review was conducted on Pubmed. It included English or Portuguese articles published in the last five years describing adult patients treated with vonoprazan and/or PPI for GERD, H. pylori, or post-endoscopic dissection of the gastroesophageal submucosa bleeding and ulcers. There were six articles on GERD. Half suggested vonoprazan was superior to PPIs, while the other half considered it non-inferior or of comparable efficacy. There were 19 articles on H. pylori eradication, and vonoprazan outperformed PPI in 68,42% (13/19) of them. Vonoprazan was more effective than PPIs in 8 of the 13 studies chosen for post-ESD and ulcer prevention. As a result, in most studies, vonoprazan is either superior or not inferior to PPIs. However, the racial bias of the results is a significant limitation, as many of these studies were conducted in the Japanese population. More research on greater racial diversity is required. Nonetheless, in the current scenario, vonoprazan is a potential alternative pharmacological treatment for post-ESD bleeding and ulcers, GERD, and H. pylori.

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Section: Primary-line Treatmentmentioning

confidence: 72%

Vonoprazan: A systematic review of an alternative to proton pump inhibitors

Silva¹,

Figueiredo²,

Gonçalves³

et al. 2022

GHOA

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“…1 ). Of the gastric acid‐related diseases, six were erosive esophagitis, 18 , 19 , 20 , 21 , 22 , 23 two were symptomatic GERD, 24 , 25 nine were H. pylori infection, 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 three were gastric ulcers, 34 , 35 , 36 and the remaining two were duodenal ulcers 33 , 35 (Table 1 ). All studies were peer‐reviewed published clinical trials except for two unpublished clinical trials.…”

Section: Resultsmentioning

confidence: 99%

A comparison of efficacy and safety of potassium‐competitive acid blocker and proton pump inhibitor in gastric acid‐related diseases: A systematic review and meta‐analysis

Simadibrata

Syam

Lee

2022

J of Gastro and Hepatol

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Background and Aim: Potassium-competitive acid blocker (PCAB) is a recent alternative to proton pump inhibitor (PPI) for potent acid suppression. The current systematic review and meta-analysis aimed to compare the efficacy and safety of PCAB versus PPI in treating gastric acid-related diseases. Methods: We searched up to June 5, 2022, for randomized controlled trials of gastric acid-related diseases that included erosive esophagitis, symptomatic gastroesophageal reflux disease (GERD), peptic ulcers, and Helicobacter pylori infection. The pooled risk ratio (RR) was evaluated for the efficacy outcome and treatment-emergent adverse events (TEAEs) as the safety outcome. Sensitivity analyses were performed to test the robustness of the study findings. Results: Of the 710 screened studies, 19 studies including 7023 participants were analyzed. The RRs for the healing of erosive esophagitis with Vonoprazan versus PPI were 1.09 (95% confidence interval [CI] 1.03-1.14), 1.03 (95% CI 1.00-1.07), and 1.02 (95% CI 1.00-1.05) in Weeks 2, 4, and 8, respectively. There were no differences in the improvement of GERD symptoms and healing of gastric and duodenal ulcers between PCAB and PPI. The pooled eradication rates of H. pylori were significantly higher in Vonoprazan versus PPI first-line treatment (RR 1.13; 95% CI 1.04-1.22). The overall RR of TEAEs with Vonoprazan versus PPI was 1.08 (95% CI 0.89-1.31). Overall, the risk of bias was low to some concerns. Furthermore, sensitivity analyses confirmed the robustness of the study's conclusion. Conclusion:Vonoprazan is superior to PPI in first-line H. pylori eradication and erosive esophagitis but non-inferior in other gastric acid-related diseases. Likewise, short-term safety is comparable in both treatment groups.

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“…In trials conducted by X. Hou et al [42] and H. Miwa et al [43] found vonoprazan 20 mg to be no inferior to lansoprazole 30 mg in the treatment of DU, with similar side effects. They also observed that gastrin levels were higher in patients treated with vonoprazan.…”

Section: Vonoprazan and Duodenal Ulcers (Du)mentioning

confidence: 96%

Vonoprazan - a new drug for inhibiting gastric acid secretion

Niewęgłowski

Wilczek

Rycharski³

et al. 2022

J Educ Health Sport

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Introduction and purpose Vonoprazan is a potassium-competent acid blocker (P-CAB). It has the potential to be an alternative to proton pump inhibitors (PPIs) as it inhibits hydrochloric acid secretion. The mechanism of action is different than PPIs - vonoprazan reversibly inhibits gastric H+, K+-ATPase, while PPIs irreversibly. Vonoprazan is approved for use in Japan and the US. The aim of the study was to review articles on the use of vonoprazan instead of PPIs in the treatment of acid-related gastrological diseases and to present the results obtained. A brief description of the state of knowledge Vonoprazan is used in the treatment of acid-related gastrological diseases. The 20 mg dose is suitable for most diseases, such as treatment of ulcers during low-dose aspirin treatment, post-endoscopic submucosal dissection (post-ESD) ulcers, erosive esophagitis (EE) in gastroesophageal reflux disease (GERD), and Helicobacter pylori eradication. Summary Researches suggest that the drug is an alternative for PPIs and can be used instead of them. The main advantage of this drug over PPIs is that it works faster, more potent and long-lasting. Studies suggest that vonoprazan can be use to treatment of the acid-related diseases and may be a better choice than PPIs. Vonoprazan may have a particular use in the treatment of PPI-refractory GERD. In post-ESD ulcers, a significant benefit in treatment effects of vonoprazan over PPIs cannot be clearly concluded.

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Vonoprazan non‐inferior to lansoprazole in treating duodenal ulcer and eradicating Helicobacter pylori in Asian patients

Cited by 38 publications

References 39 publications

Vonoprazan: A systematic review of an alternative to proton pump inhibitors

Vonoprazan: A systematic review of an alternative to proton pump inhibitors

A comparison of efficacy and safety of potassium‐competitive acid blocker and proton pump inhibitor in gastric acid‐related diseases: A systematic review and meta‐analysis

Vonoprazan - a new drug for inhibiting gastric acid secretion

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