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13 February 2019 : Meta-Analysis  

Comparison of the Use of Vonoprazan and Proton Pump Inhibitors for the Treatment of Peptic Ulcers Resulting from Endoscopic Submucosal Dissection: A Systematic Review and Meta-Analysis

Hui-Si He1BCDEF, Bing-Yang Li1ABCDEF, Qi-Tong Chen2ABCDE, Chun-Yan Song3ABCD, Jian Shi4ABCDEF, Bin Shi4ABCDE*

DOI: 10.12659/MSM.911886

Med Sci Monit 2019; 25:1169-1176


BACKGROUND: Currently, proton pump inhibitors (PPIs) are the first-line treatment for ulcers resulting from endoscopic submucosal dissection (ESD). Vonoprazan is a new oral potassium-competitive acid blocker (P-CAB). The aim of this systematic review and meta-analysis was to compare the efficacy, safety, and tolerance of vonoprazan with PPIs in the treatment of peptic ulcers resulting from ESD.

MATERIAL AND METHODS: Published results of randomized clinical trials (RCTs) comparing vonoprazan with PPIs in the treatment of ulcers resulting from ESD were identified up to March 2018. The main clinical endpoints evaluated were healing rate and adverse events. The meta-analysis included quality assessment of the studies, statistical analysis of endpoints, and sensitivity analysis using Revman version 5.3 meta-analysis software.

RESULTS: Systematic literature review identified seven published studies that included 548 patients. Five studies were published as full-text manuscripts, and two studies were published as abstracts. Meta-analysis of the vonoprazan treatment, compared with PPI treatment, for ESD showed that the pooled relative risk (RR) of healing rate was 0.64 (95% CI, 0.33–1.22) for the 4-week study group and 0.98 (95% CI, 0.84–1.15) for the 8-week study group. The RR for adverse events was 0.65 (95% CI, 0.31–1.38) (P>0.05). No statistical evidence of publication bias was found.

CONCLUSIONS: The findings of the systematic review and meta-analysis showed that the efficacy of vonoprazan was comparable with PPIs for the treatment of peptic ulcers following ESD. Further studies are required to support the safety and efficacy of vonoprazan compared with different types of PPIs.

Keywords: meta-analysis, Peptic Ulcer, proton pump inhibitors, endoscopic mucosal resection, Postoperative Complications, Pyrroles, Sulfonamides, Treatment Outcome, Wound Healing

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01 October 2023 : Editorial  

Editorial: Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2023 Guidelines for COPD, Including COVID-19, Climate Change, and Air Pollution

Dinah V. Parums
Science Editor, Medical Science Monitor, International Scientific Information, Inc., Melville, NY, USA

DOI: 10.12659/MSM.942672

Med Sci Monit 2023; 29:e942672


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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750