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中国一线治疗中基于 10 天 vonoprazan 与 14 天质子泵抑制剂的幽门螺杆菌根除治疗:一项随机对照试验的荟萃分析。

Ten-day vonoprazan-based versus fourteen-day proton pump inhibitor-based therapy for first-line Helicobacter pylori eradication in China: A meta-analysis of randomized controlled trials.

机构信息

Department of Pharmacy, Central Hospital Affiliated to Shandong First Medical University, Jinan, China.

出版信息

Int J Immunopathol Pharmacol. 2024 Jan-Dec;38:3946320241286866. doi: 10.1177/03946320241286866.

Abstract

A shorter treatment duration potentially offers the advantage of reducing adverse events (AEs) and enhancing patient compliance for Helicobacter pylori eradication. However, the difference in eradication rates between short-duration vonoprazan-based regimens and fourteen-day proton pump inhibitor (PPI)-based therapy remained unknown. This meta-analysis aimed to compare the efficacy and safety of ten-day vonoprazan-based regimens with fourteen-day conventional PPI-based therapy for eradication. We performed a comprehensive literature search up to November 28, 2023, using PubMed. A random-effects model was applied to conduct a meta-analysis to determine the pooled Odds Ratio (OR) with 95% confidence intervals (CIs). This meta-analysis included four randomized controlled clinical trials with 1560 patients. The eradication rate of ten-day vonoprazan-based regimens was comparable to that of fourteen-day PPI-based therapy (88.7% vs 82.9%, OR 1.53, 95% CI [0.85-2.75], = .16) in ITT analysis. The incidence of AEs in ten-day vonoprazan-based therapy was also similar to the control group (11.2% vs 17.6%, OR 0.66, 95% CI [0.33-1.31], = .24). Current evidence suggests that the ten-day vonoprazan-based regimen is as effective as fourteen-day PPI-based therapy in eradicating , with comparable AEs. However, additional research is required for confirmation.

摘要

较短的治疗疗程可能具有减少不良反应(AE)和提高幽门螺杆菌根除治疗患者依从性的优势。然而,基于短疗程沃诺拉赞的方案与十四天质子泵抑制剂(PPI)为基础的治疗方案之间的根除率差异仍不清楚。本荟萃分析旨在比较基于沃诺拉赞的十天方案与十四天常规 PPI 为基础的治疗方案在根除方面的疗效和安全性。我们进行了全面的文献检索,截至 2023 年 11 月 28 日,使用 PubMed。应用随机效应模型进行荟萃分析,以确定合并优势比(OR)及其 95%置信区间(CI)。本荟萃分析纳入了四项随机对照临床试验,共 1560 名患者。意向治疗(ITT)分析显示,基于沃诺拉赞的十天方案的根除率与十四天 PPI 为基础的治疗方案相当(88.7%比 82.9%,OR 1.53,95%CI [0.85-2.75], =.16)。基于沃诺拉赞的十天方案治疗的 AE 发生率也与对照组相似(11.2%比 17.6%,OR 0.66,95%CI [0.33-1.31], =.24)。目前的证据表明,基于沃诺拉赞的十天方案在根除方面与十四天 PPI 为基础的治疗方案同样有效,AE 发生率相当。然而,还需要进一步的研究来证实。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1427/11418347/4d90b3820b71/10.1177_03946320241286866-fig1.jpg

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