Comparison of tegoprazan-based and proton pump inhibitor-based regimens for Helicobacter pylori eradication: a meta-analysis and systematic review

TL;DR

This study compares tegoprazan and proton pump inhibitor treatments for Helicobacter pylori and finds similar effectiveness and safety.

Contribution

The study provides a meta-analysis comparing tegoprazan-based and proton pump inhibitor-based regimens for Helicobacter pylori eradication.

Findings

Tegoprazan-based and PPI-based regimens had comparable eradication rates and compliance.

Tegoprazan-based regimens had significantly lower adverse event rates than PPI-based regimens.

Subgroup analyses showed higher eradication rates in specific treatment conditions but no significant differences within subgroups.

Abstract

Tegoprazan (TEG) is a novel potassium-competitive acid blocker (P-CAB) that provides long-lasting acid-suppressing effects. The role of TEG-based Helicobacter pylori (H. pylori) eradication regimens in comparison to proton pump inhibitor (PPI)-based regimens requires further investigation.

We conducted a comprehensive search across multiple databases. Studies comparing H. pylori eradication rates, adverse events (AEs), and compliance between TEG-based and PPI-based regimens were included. Statistical analyses were performed using RevMan 5.4.

A total of eight studies involving 4,640 patients were included. Based on intention-to-treat (ITT) analyses, the overall eradication rate (78.6% vs. 76.6%; odds ratio [OR] = 1.08, 95% CI: 0.93–1.24; p = 0.31, I2 = 0%) and compliance (97.8% vs. 97.8%; OR = 1.16, 95% CI: 0.54–2.50; p = 0.33, I2 = 13%) were comparable between the TEG and PPI groups. The AE rate of TEG-based regimens was significantly lower than that of PPI-based regimens (30.8% vs. 34.9%; OR = 0.88; 95% CI: 0.78–1.00; p = 0.04, I2 = 67%), although this difference was not significant in the randomized controlled trials (RCTs). The subgroup analyses showed higher eradication rates in studies conducted in China, those with treatment durations of 10 or 14 days, and those using dual or bismuth quadruple regimens. However, the treatment regimens did not significantly influence eradication rates within any subgroup.

TEG-based H. pylori eradication treatment demonstrated similar eradication rates, compliance, and safety to PPI-based regimens.

https://www.crd.york.ac.uk/PROSPERO/view/CRD42024629665.

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