In:
Digestion, S. Karger AG, Vol. 102, No. 3 ( 2021), p. 319-325
Abstract:
〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 A novel potassium-competitive acid blocker, vonoprazan (VPZ), improves first-line 〈 i 〉 Helicobacter pylori 〈 /i 〉 eradication success. The aim of this systematic review is to clarify the effectiveness and safety of second-line 〈 i 〉 H. pylori 〈 /i 〉 eradication therapy comparing VPZ and proton pump inhibitor (PPI)-based regimens. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Medline (PubMed), EMBASE, Web of Science, Cochrane Library, and the Japan Medical Abstract Society Database were searched. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 We selected 16 studies for quantitative review. Forest plot analysis showed significant superiority of VPZ over PPI-based regimens in overall second-line 〈 i 〉 H. pylori 〈 /i 〉 eradication success (OR 1.51, 95% CI 1.27–1.81, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001). Forest plots from 2 studies with propensity score matched analysis showed significant superiority of VPZ over PPI-based regimens (OR 3.09, 95% CI 1.71–5.58, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001). The remaining 14 studies with per-protocol analysis and the full analysis set also showed significant superiority (OR 1.40, 95% CI 1.16–1.69, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001). Regarding adverse events, Forest plot analysis did not show a significant difference between the 2 regimens (OR 0.88, 95% CI 0.58–1.32, 〈 i 〉 p 〈 /i 〉 = 0.53). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 A VPZ-based regimen has significant superiority over a PPI-based regimen for second-line 〈 i 〉 H. pylori 〈 /i 〉 eradication therapy. A VPZ-based second-line 〈 i 〉 H. pylori 〈 /i 〉 eradication regimen can be the first choice.
Type of Medium:
Online Resource
ISSN:
0012-2823
,
1421-9867
Language:
English
Publisher:
S. Karger AG
Publication Date:
2021
detail.hit.zdb_id:
1482218-0
Permalink