Caspian Journal of Internal Medicine

en Efficacy and safety of potassium-competitive acid blockers in eradicating Helicobacter pylori and treating gastro-esophageal reflux disease: A systematic review and meta-analysis Gastroentrology Gastroentrology Original Article Original Article Background: This systematic review aimed to assess the efficacy and safety of PCAB versus PPI in eradicating H. pylori and GERD. Methods: The studies were searched through databases of PubMed, ScienceDirect, Wiley Online Library, and CENTRAL. A random-effects meta-analysis was performed to evaluate the efficacy and safety of PCAB in eradicating H. pylori and treating GERD, using odds ratios (OR) and 95% confidence intervals (95%CI) as the effect measures. Results: PCAB therapy demonstrated superior efficacy and safety compared to PPI-based therapy in eradicating H. pylori (efficacy OR 1.40 [95% CI 1.12–1.76]; safety OR 0.71 [0.52–0.95]) and treating GERD (efficacy OR 1.62 [1.01–2.61]; safety OR 0.90 [0.71–1.14]). Vonoprazan therapy, but not tegoprazan, particularly showed superiority, with ORs of 1.66 [1.24–2.23] for H. pylori eradication (safety OR 0.71 [0.52–0.95]) and 1.80 [1.00–3.25] for GERD (safety OR 1.03 [0.83–1.27]). For H. pylori eradication, vonoprazan triple therapy showed greater efficacy overall (OR 1.94 [1.19–3.17]) and compared to lansoprazole (OR 2.84 [1.97–4.11]) and rabeprazole (OR 2.63 [1.05–6.58]), though not compared to esomeprazole (OR 1.62 [0.69–3.81]). In GERD treatment, both short-term (8 weeks) and long-term (24 weeks) vonoprazan therapies were similarly effective (OR 2.55 [1.71–3.80] and OR 2.17 [1.00–4.72], respectively) and showed particular efficacy in patients with severe (grade C/D) reflux esophagitis (OR 3.51 [1.65–7.46]). Conclusions: Vonoprazan had a superior efficacy than PPI in eradicating H. pylori and treating GERD, but not for tegoprazan. PCAB demonstrated a favorable safety profile. Gastro-Esophageal Reflux Disease, Helicobacter Pylori, Proton Pump Inhibitor, Tegoprazan, Vonoprazan. 14 36 http://caspjim.com/browse.php?a_code=A-10-3495-1&slc_lang=en&sid=1 Ni Nyoman Gita Kharisma Dewi gitakharismadewi78@gmail.com 100319475328460055729 100319475328460055729 No Centre Research for Alimentary and Hepatobiliary System, Denpasar, Bali, Indonesia Ni Luh Putu Yunia Dewi dputuyunia@gmail.com 100319475328460055730 100319475328460055730 No Centre Research for Alimentary and Hepatobiliary System, Denpasar, Bali, Indonesia Putu Itta Sandi Lesmana Dewi ittadewi99@gmail.com 100319475328460055731 100319475328460055731 No Centre Research for Alimentary and Hepatobiliary System, Denpasar, Bali, Indonesia Kadek Mercu Narapati Pamungkas mercunarapati@gmail.com 100319475328460055732 0009-0001-0418-2652 No Centre Research for Alimentary and Hepatobiliary System, Denpasar, Bali, Indonesia Dwijo Anargha Sindhughosa dwijo_anargha@unud.ac.id 100319475328460055733 100319475328460055733 No Division of Gastroenterology and Hepatology, Department of Internal Medicine, Udayana University/Prof. Dr. I.G.N.G. Ngoerah Hospital, Bali I Ketut Mariadi mariadi@unud.ac.id 100319475328460055734 100319475328460055734 Yes Division of Gastroenterology and Hepatology, Department of Internal Medicine, Udayana University/Prof. Dr. I.G.N.G. Ngoerah Hospital, Bali