PMID- 38353152
OWN - NLM
STAT- Publisher
LR  - 20240214
IS  - 1440-1746 (Electronic)
IS  - 0815-9319 (Linking)
DP  - 2024 Feb 14
TI  - Vonoprazan is superior to lansoprazole for healing of severe but not mild erosive 
      esophagitis: A systematic review with meta-analysis of randomized controlled 
      trials.
LID - 10.1111/jgh.16486 [doi]
AB  - BACKGROUND AND AIM: Healing rates of severe erosive esophagitis (EE; Los Angeles 
      [LA] Grade C/D) in patients treated with a proton pump inhibitor (PPI) is 
      suboptimal (~60-70%). Vonoprazan, a potassium-competitive acid blocker, is 
      suggested to have better healing rates in patients with severe EE. This 
      meta-analysis compares the efficacy and safety of vonoprazan 20 mg versus 
      lansoprazole 30 mg daily in healing EE, specifically in those with LA Grade C/D. 
      METHODS: We searched MEDLINE, Embase, and CENTRAL on May 24, 2023. Studies that 
      randomized EE patients to vonoprazan 20 mg daily or lansoprazole 30 mg daily and 
      compared healing rates were included. The risk of bias was assessed using 
      Cochrane's Risk of Bias 2 tool. The fixed-effect model was used to obtain the 
      pooled efficacy and safety outcomes. Subgroup analysis was done to compare 
      healing rates in mild (LA Grade A/B) versus severe EE and based on study 
      location. RESULTS: Four randomized controlled trials (RCTs) with low risks of 
      bias comprising 2208 participants were included. Vonoprazan 20 mg was superior to 
      lansoprazole 30 mg daily in healing severe EE at all weeks (Week 2 RR 1.294 [95% 
      CI 1.169-1.433], Week 4 1.160 [1.059-1.270], and Week 8 1.175 [95% CI 
      1.107-1.247]), but was similar for mild EE at all weeks (P-interaction < 0.01). 
      Vonoprazan 20 mg was more efficacious than lansoprazole 30 mg at Week 8 in 
      Western versus Asian studies (P-interaction < 0.01). Any, serious, and 
      drug-related treatment-emergent adverse events were comparable between groups. 
      CONCLUSION: Vonoprazan 20 mg is superior to lansoprazole 30 mg for healing severe 
      EE but not mild EE. Vonoprazan 20 mg daily has a similar safety profile to 
      lansoprazole 30 mg daily.
CI  - (c) 2024 Journal of Gastroenterology and Hepatology Foundation and John Wiley & 
      Sons Australia, Ltd.
FAU - Simadibrata, Daniel Martin
AU  - Simadibrata DM
AUID- ORCID: 0000-0002-7512-2112
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      USA.
AD  - Nuffield Department of Population Health, University of Oxford, Oxford, UK.
FAU - Lesmana, Elvira
AU  - Lesmana E
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      USA.
AD  - Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
FAU - Fass, Ronnie
AU  - Fass R
AD  - Division of Gastroenterology and Hepatology, MetroHealth Medical System, Case 
      Western Reserve University, Cleveland, Ohio, USA.
LA  - eng
PT  - Journal Article
DEP - 20240214
PL  - Australia
TA  - J Gastroenterol Hepatol
JT  - Journal of gastroenterology and hepatology
JID - 8607909
SB  - IM
OTO - NOTNLM
OT  - erosive esophagitis
OT  - lansoprazole
OT  - potassium-competitive acid blocker
OT  - proton pump inhibitor
OT  - vonoprazan
EDAT- 2024/02/14 06:43
MHDA- 2024/02/14 06:43
CRDT- 2024/02/14 05:42
PHST- 2023/12/12 00:00 [revised]
PHST- 2023/07/07 00:00 [received]
PHST- 2023/12/27 00:00 [accepted]
PHST- 2024/02/14 06:43 [medline]
PHST- 2024/02/14 06:43 [pubmed]
PHST- 2024/02/14 05:42 [entrez]
AID - 10.1111/jgh.16486 [doi]
PST - aheadofprint
SO  - J Gastroenterol Hepatol. 2024 Feb 14. doi: 10.1111/jgh.16486.