Efficacy of Vonoprazan in the treatment of gastroesophageal refluxe disease: A meta-analysis

doi:10.3877/cma.j.issn.2095-8765.2022.02.004

Abstract

Abstract:

Objective

To evaluate the efficacy of Vonoprazan to treat gastroesophageal reflux disease (GERD).

Methods

The randomized controlled trials of Vonoprazan in the treatment of gastroesophageal reflux disease were retrieved in the Cochrane Library, PubMed, EMBASE, China Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), and WanFang Data. The key words included "Vonoprazan", "TAK-438","gastroesophageal reflux", "GERD", "erosive esophagitis", "non-erosive reflux disease", "reflux esophagitis". Data extraction and the evaluation of the inclusive literature quality were conducted independently by 2 reviewers . Meta-analysis was carried out by the RevMan software5.4.

Results

we obtained 108 publications through searching the literature dababase and cited references. And after removal of the study with the exclusive criteria, 10 remained. In the main analysis, there was no significant difference (P>0.05) in the efficacy between Vonoprazan and the control group (RR=1.07, 95%CI: 1.01-1.13). In the baseline analysis, the subgroup analysis showed significant effective therapy in the severe esophagitis (LA grade C/D) compared with the proton pump inhibitors (PPIs) (RR=1.14, 95%CI: 1.06-1.22; P<0.05). however, the analysis results indicated that no significant difference cound be seen in different doses of vonoprazan as a therapy in GERD. (P>0.05) (RR=1.36, 95% CI: 1.03-1.79).

Conclusion

Vonoprazan is more effective than PPIs in the treatment of GERD, especially in severe esophagitis (LA grade C/D). The safety is similar to PPIs. And 10mg, 20mg, or 40 mg vonoprazan present with the same efficacy in the treatment of GERD.

Key words: gastroesophageal reflux disease, Vonoprazan, meta-analysis, reflux esophagitis

Lunsheng Lou, Yurong Huang, Lei He, Dongmei Chen, Guoyi Mo, Jie Yang. Efficacy of Vonoprazan in the treatment of gastroesophageal refluxe disease: A meta-analysis[J]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2022, 09(02): 95-102.

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Figures/Tables 10

References 23

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作者	国家	出版年份	干预措施	持续时间	有效率	结局指标	病例数（I/C）
Ashida et al^［5］	日本	2015	Vo 20 mg vs Lan 30 mg	8 周	96.5% vs 95.5%	愈合率	276（144/132）
Ashida et al^［6］	日本	2016	Vo 20 mg vs Lan 30 mg	8 周	99% vs 96%	愈合率	404（205/199）
Iwakiri et al^［7］	日本	2017	Vo 20 mg vs Vo 40 mg	8 周	60% vs 71.4%	愈合率	12（5/7）
Ashida et al^［8］	日本	2018	Vo 20 mg vs Lan 15 mg	24 周	98% vs 83.2%	愈合率	397（201/196）
Oshima et al^［9］	日本	2019	Vo 20 mg vs Lan 30 mg	1 周	68.8% vs 25%	症状缓解	32（16/16）
Sakurai et al^［10］	日本	2019	Vo 20 mg vs Es 20 mg	4 周	81.8% vs 88%	症状缓解	47（22/25）
Xiao et al^［11］	中国	2020	Vo 20 mg vs Lan 30 mg	8 周	92.4% vs 91.3%	愈合率	468（238/230）
Okanobu et al^［12］	日本	2021	Vo 20 mg vs Vo 10 mg	4 周	64.6% vs 94.4%	愈合率	72（37/36）
黄博等^［13］	中国	2021	Vo 20 mg vs Eso20 mg	4 周	93.3% vs 63.3.%	愈合率	60（30/30）
MatsudaS et al^［14］	日本	2022	Vo 10 mg vs Lan 15 mg	8 周	59.8% vs 54.5%	症状缓解	224（67/61）

作者	国家	出版年份	干预措施	持续时间	有效率	结局指标	病例数（I/C）
Ashida et al^［5］	日本	2015	Vo 20 mg vs Lan 30 mg	8 周	96.5% vs 95.5%	愈合率	276（144/132）
Ashida et al^［6］	日本	2016	Vo 20 mg vs Lan 30 mg	8 周	99% vs 96%	愈合率	404（205/199）
Iwakiri et al^［7］	日本	2017	Vo 20 mg vs Vo 40 mg	8 周	60% vs 71.4%	愈合率	12（5/7）
Ashida et al^［8］	日本	2018	Vo 20 mg vs Lan 15 mg	24 周	98% vs 83.2%	愈合率	397（201/196）
Oshima et al^［9］	日本	2019	Vo 20 mg vs Lan 30 mg	1 周	68.8% vs 25%	症状缓解	32（16/16）
Sakurai et al^［10］	日本	2019	Vo 20 mg vs Es 20 mg	4 周	81.8% vs 88%	症状缓解	47（22/25）
Xiao et al^［11］	中国	2020	Vo 20 mg vs Lan 30 mg	8 周	92.4% vs 91.3%	愈合率	468（238/230）
Okanobu et al^［12］	日本	2021	Vo 20 mg vs Vo 10 mg	4 周	64.6% vs 94.4%	愈合率	72（37/36）
黄博等^［13］	中国	2021	Vo 20 mg vs Eso20 mg	4 周	93.3% vs 63.3.%	愈合率	60（30/30）
MatsudaS et al^［14］	日本	2022	Vo 10 mg vs Lan 15 mg	8 周	59.8% vs 54.5%	症状缓解	224（67/61）

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