Tegoprazan-Containing Versus Proton Pump Inhibitor-Containing Therapy for First-Line Eradication of Helicobacter pylori: A Meta-Analysis of Randomized Controlled Trials

IF 1.7 Q3 GASTROENTEROLOGY & HEPATOLOGY

JGH Open Pub Date : 2025-03-12 DOI:10.1002/jgh3.70134

Daniel Martin Simadibrata, Elvira Lesmana, Ivan Damara, Mochammad Izzatullah, Pojsakorn Danpanichkul, Hae Won Yoo, Su Jin Hong, Ari Fahrial Syam

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Abstract

Introduction

Concerns have been raised regarding the decreasing success rates of the standard treatment of Helicobacter pylori (proton pump inhibitor (PPI) and two/three antibiotics) and the long-term effects carried by PPI. Despite conflicting data, Tegoprazan, a potassium-competitive acid blocker, is hypothesized to be superior to PPI for eradicating H pylori. This systematic review and meta-analysis aim to determine the superiority of Tegoprazan-containing therapy to PPI-containing therapy for H pylori eradication.

Methods

A systematic literature search identified studies published until December 12, 2024, from MEDLINE, EMBASE, SCOPUS, and CENTRAL. The search strategy included the following keywords: “Tegoprazan,” “Proton Pump Inhibitors,” and “Helicobacter pylori.” Only randomized controlled trials (RCTs) that compared the efficacy of Tegoprazan to any PPI were included. Risk of bias assessment was performed using the Cochrane Risk of Bias 2 (RoB2) tool for RCTs. The random-effect model was used to calculate the pooled risk ratio (RR) and its 95% Confidence Interval (95% CI) from the intention-to-treat population.

Results

Six RCTs with low risks of bias were included in this meta-analysis. All studies included treatment-naïve patients and compared first-line H pylori treatment. The overall eradication rates of Tegoprazan-containing (N = 1052) versus PPI-containing therapy (N = 1058) were 83.37% and 80.06%, respectively (RR 1.045; 95% CI 1.008–1.084; I² = 0%). Tegoprazan-containing therapy demonstrated comparable treatment-emergent adverse event (TEAE) rates compared to PPI-containing therapy (46.48% vs. 46.31%; RR 1.026; 95% CI 0.952–1.106; I² = 48%).

Conclusion

This meta-analysis demonstrated that Tegoprazan-containing therapy is superior to PPI-containing therapy for first-line H pylori eradication, with comparable safety profiles.

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含替戈拉赞与含质子泵抑制剂治疗一线根除幽门螺杆菌：随机对照试验的荟萃分析

关于幽门螺杆菌标准治疗（质子泵抑制剂（PPI）和二/三种抗生素）的成功率下降以及PPI带来的长期影响，人们提出了关注。尽管有相互矛盾的数据，但假设Tegoprazan，一种钾竞争性酸阻滞剂，在根除幽门螺杆菌方面优于PPI。本系统综述和荟萃分析旨在确定含替戈拉赞治疗与含ppi治疗在根除幽门螺杆菌方面的优势。方法系统检索MEDLINE、EMBASE、SCOPUS和CENTRAL中截止2024年12月12日发表的研究。搜索策略包括以下关键词：“Tegoprazan”、“质子泵抑制剂”和“幽门螺杆菌”。仅纳入比较替戈拉赞与任何PPI疗效的随机对照试验（rct）。使用Cochrane风险偏倚2 （RoB2）工具对随机对照试验进行偏倚风险评估。随机效应模型用于计算意向治疗人群的合并风险比（RR）及其95%置信区间（95% CI）。结果本荟萃分析纳入6项低偏倚风险的随机对照试验。所有研究纳入treatment-naïve患者并比较一线幽门螺杆菌治疗。含替戈拉赞治疗（N = 1052）和含ppi治疗（N = 1058）的总根除率分别为83.37%和80.06% (RR = 1.045；95% ci 1.008-1.084；i2 = 0%)。与含有ppi的治疗相比，含有替戈拉赞的治疗显示出相当的治疗突发不良事件（TEAE）率(46.48% vs 46.31%；RR 1.026;95% ci 0.952-1.106；i2 = 48%)。结论本荟萃分析表明，在一线根除幽门螺杆菌方面，含替戈拉赞治疗优于含ppi治疗，且安全性相当。

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