Efficacy of Potassium-Competitive Acid Blockers Versus Proton Pump Inhibitors for Gastric Ulcers: Bayesian and Frequentist Network Meta-Analysis With Cross-Inference Through a Quality management System

IF 1.5 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Current Therapeutic Research-clinical and Experimental Pub Date : 2025-01-01 DOI:10.1016/j.curtheres.2025.100776

In Mo Yoon MD, PhD , Kang-Yon Kim MD , Kwan-Haeng Lee MD , Duk-Woo Yoo DMD , Hojin Oh PharmD

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引用次数: 0

Abstract

Purpose

Proton pump inhibitors (PPIs) have been the mainstay treatment for gastric ulcer (GU) for over 30 years. However, since the discovery of a new class of acid suppressants, potassium-competitive acid blockers (P-CABs), the desire for a therapeutic agent has continued and the clinical trials on P-CABs have been conducted. In this regard, we aimed to assess whether P-CABs are noninferior to PPIs in patients with GU in terms of efficacy.

Methods

We performed a systematic review and network meta-analysis (NMA) based on randomized controlled trials (RCTs). Additionally, we used a new methodology of inference concept with the purpose of grouping between P-CABs and PPIs. Moreover, our quality management system was integrated throughout the research to ensure data accuracy.

Findings

We initially screened 438 studies and extracted 10 homogeneous GU RCTs with 6315 participants. The odds ratios (ORs) for the 4-week cure rate in Bayesian + frequentist NMA, tegoprazan 100 mg (OR = 4.14, 95% credible interval [CI] 0.56–26.3) and pantoprazole 40 mg (OR = 4.12, 95% CI 1.90–8.88) were the largest, respectively. The ORs for the 8-week cure rate in Bayesian + frequentist NMA, lansoprazole 30 mg (OR = 8.77, 95% credible interval [CI] 0.95–78.9) and lansoprazole 30 mg (OR = 7.91, 95% CI 2.60–24.03) was the largest, respectively.

Conclusions

The results of the NMA reveal that the cure rates of P-CABs in cases of GU were not inferior to those of PPIs. As the inference by grouping PPIs and P-CABs, the results showed similar trends in terms of effectiveness between the two therapeutic classes.

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钾竞争性酸阻滞剂与质子泵抑制剂对胃溃疡的疗效：通过质量管理体系交叉推断的贝叶斯和频率网络meta分析

目的质子泵抑制剂（PPIs）作为治疗胃溃疡（GU）的主要药物已有30多年的历史。然而，由于发现了一类新的酸抑制剂，钾竞争酸阻滞剂（p - cab），对治疗药物的渴望一直在继续，p - cab的临床试验已经进行了。在这方面，我们的目的是评估p - cab在GU患者的疗效方面是否优于PPIs。方法采用随机对照试验（RCTs）进行系统评价和网络荟萃分析（NMA）。此外，我们使用了一种新的推理概念方法，目的是在p - cab和ppi之间进行分组。此外，我们的质量管理体系在整个研究过程中进行了整合，以确保数据的准确性。研究结果：我们最初筛选了438项研究，并提取了10项均匀的GU随机对照试验，共6315名受试者。贝叶斯 + 频率学家NMA中，替戈拉赞100 mg （OR = 4.14,95%可信区间[CI] 0.56 ~ 26.3）和泮托拉唑40 mg （OR = 4.12,95% CI 1.90 ~ 8.88）的4周治愈率比值比（ORs）最大。贝叶斯 + 频率学家NMA中，兰索拉唑30 mg （OR = 8.77,95%可信区间[CI] 0.95 ~ 78.9）和兰索拉唑30 mg （OR = 7.91,95% CI 2.60 ~ 24.03）的8周治愈率的OR分别最大。结论NMA结果显示，p - cab治疗GU的治愈率不低于PPIs。通过对PPIs和p - cab进行分组推断，结果显示两种治疗类别之间的有效性趋势相似。

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来源期刊

Current Therapeutic Research-clinical and Experimental 医学-药学

CiteScore

3.50

自引率

0.00%

发文量

审稿时长

3 months

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