PMID- 38345252
OWN - NLM
STAT- MEDLINE
DCOM- 20240503
LR  - 20240503
IS  - 1572-0241 (Electronic)
IS  - 0002-9270 (Linking)
VI  - 119
IP  - 5
DP  - 2024 May 1
TI  - Comparative Efficacy of P-CAB vs Proton Pump Inhibitors for Grade C/D 
      Esophagitis: A Systematic Review and Network Meta-analysis.
PG  - 803-813
LID - 10.14309/ajg.0000000000002714 [doi]
AB  - INTRODUCTION: Los Angeles grade C/D esophagitis is a severe manifestation of 
      gastroesophageal reflux disease that require active treatment and close 
      follow-up. Potassium competitive acid blockers (P-CAB) are promising alternatives 
      to proton pump inhibitors (PPI). We aimed to compare the efficacy and safety of 
      P-CAB and PPI in healing grade C/D esophagitis to aid clinical decision-making. 
      METHODS: A systematic literature search was performed using PubMed, MEDLINE, and 
      Cochrane Central Register of Controlled Trials. Randomized controlled trials were 
      eligible for inclusion if efficacy of P-CAB and PPI in healing grade C/D 
      esophagitis was reported. Pooled risk ratios and risk difference with 95% 
      credible intervals were used to summarize estimated effect of each comparison. 
      The benefit of treatments was ranked using the surface under the cumulative 
      probability ranking score. RESULTS: Of 5,876 articles identified in the database, 
      24 studies were eligible. Studies included incorporated 3 P-CAB (vonoprazan, 
      tegoprazan, and keverprazan) and 6 PPI (lansoprazole, esomeprazole, omeprazole, 
      rabeprazole extended-release (ER), pantoprazole, and dexlansoprazole). Based on 
      the failure to achieve mucosal healing, 20 mg of vonoprazan q.d. ranked the first 
      among PPI in initial and maintained healing of grade C/D esophagitis (surface 
      under the cumulative probability ranking score = 0.89 and 0.87, respectively). 
      Vonoprazan had similar risk of incurring adverse events, severe adverse events, 
      and withdrawal to drug when compared with PPI. For those who attempted lower 
      maintenance treatment dose, 10 mg of vonoprazan q.d. was a reasonable choice, 
      considering its moderate efficacy and safety. DISCUSSION: Vonoprazan has 
      considerable efficacy in initial and maintained healing of grade C/D esophagitis 
      compared with PPI, with moderate short-term and long-term safety.
CI  - Copyright (c) 2024 by The American College of Gastroenterology.
FAU - Zhuang, Qianjun
AU  - Zhuang Q
AUID- ORCID: 0000-0002-7902-291
AD  - Department of Gastroenterology and Hepatology, First Affiliated Hospital of Sun 
      Yat-sen University, Guangzhou, China.
FAU - Chen, Songfeng
AU  - Chen S
AUID- ORCID: 0000-0002-6448-0395
AD  - Department of Gastroenterology and Hepatology, First Affiliated Hospital of Sun 
      Yat-sen University, Guangzhou, China.
FAU - Zhou, Xuyu
AU  - Zhou X
AD  - Medical Information Research Institute, Sun Yat-sen University, Guangzhou, China 
      .
FAU - Jia, Xingyu
AU  - Jia X
AUID- ORCID: 0000-0003-0096-9404
AD  - Department of Gastroenterology and Hepatology, First Affiliated Hospital of Sun 
      Yat-sen University, Guangzhou, China.
FAU - Zhang, Mengyu
AU  - Zhang M
AUID- ORCID: 0000-0002-2838-1103
AD  - Department of Gastroenterology and Hepatology, First Affiliated Hospital of Sun 
      Yat-sen University, Guangzhou, China.
FAU - Tan, Niandi
AU  - Tan N
AUID- ORCID: 0000-0002-6456-7482
AD  - Department of Gastroenterology and Hepatology, First Affiliated Hospital of Sun 
      Yat-sen University, Guangzhou, China.
FAU - Chen, Fangfei
AU  - Chen F
AUID- ORCID: 0000-0002-7127-1495
AD  - Department of Gastroenterology and Hepatology, First Affiliated Hospital of Sun 
      Yat-sen University, Guangzhou, China.
FAU - Zhang, Zhanye
AU  - Zhang Z
AUID- ORCID: 0009-0003-6866-8066
AD  - Department of Gastroenterology and Hepatology, First Affiliated Hospital of Sun 
      Yat-sen University, Guangzhou, China.
FAU - Hu, Junnan
AU  - Hu J
AD  - Department of Gastroenterology and Hepatology, First Affiliated Hospital of Sun 
      Yat-sen University, Guangzhou, China.
FAU - Xiao, Yinglian
AU  - Xiao Y
AD  - Department of Gastroenterology and Hepatology, First Affiliated Hospital of Sun 
      Yat-sen University, Guangzhou, China.
LA  - eng
GR  - 2023A1515010187/Natural Science Foundation of Guangdong Province/
GR  - 2022A1515111159/Provincial and municipal joint fund youth project of guangdong/
GR  - 81970479/National Natural Science Foundation of China/
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20240212
PL  - United States
TA  - Am J Gastroenterol
JT  - The American journal of gastroenterology
JID - 0421030
RN  - 0 (Proton Pump Inhibitors)
RN  - 0 
      (1-(5-(2-fluorophenyl)-1-(pyridin-3-ylsulfonyl)-1H-pyrrol-3-yl)-N-methylmethanamine)
RN  - 0 (Pyrroles)
RN  - 0 (Sulfonamides)
SB  - IM
MH  - Humans
MH  - *Proton Pump Inhibitors/therapeutic use
MH  - *Network Meta-Analysis
MH  - Esophagitis/drug therapy
MH  - Gastroesophageal Reflux/drug therapy
MH  - Treatment Outcome
MH  - Randomized Controlled Trials as Topic
MH  - Esophagitis, Peptic/drug therapy
MH  - *Pyrroles
MH  - *Sulfonamides
EDAT- 2024/02/12 15:43
MHDA- 2024/05/03 12:52
CRDT- 2024/02/12 08:11
PHST- 2023/08/27 00:00 [received]
PHST- 2024/01/30 00:00 [accepted]
PHST- 2024/05/03 12:52 [medline]
PHST- 2024/02/12 15:43 [pubmed]
PHST- 2024/02/12 08:11 [entrez]
AID - 00000434-202405000-00013 [pii]
AID - 10.14309/ajg.0000000000002714 [doi]
PST - ppublish
SO  - Am J Gastroenterol. 2024 May 1;119(5):803-813. doi: 
      10.14309/ajg.0000000000002714. Epub 2024 Feb 12.