Department of Elderly Digestive, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China .
Clin Transl Gastroenterol. 2024 Nov 1;15(11):e00776. doi: 10.14309/ctg.0000000000000776.
Potassium-competitive acid blockers have emerged as a promising treatment of acid-related disorders. However, the optimal dosage for maximizing their efficacy remains unclear. The aim of this network meta-analysis was to compare the efficacy and safety of various dosages of potassium-competitive acid blockers and proton-pump inhibitors for treating acid-related disorders.
We searched PubMed, Embase, Cochrane Library, and Web of Science from inception to July 16, 2023. Data extraction was performed independently by 2 authors. The Cochrane Risk of Bias in Randomized Trials tool (RoB 2.0) was used for bias assessment. The efficacy and safety were compared using the odds ratio with 95% confidence intervals.
Twelve articles were included in the present meta-analysis. For gastric/duodenal ulcers, keverprazan 30 mg (K30) exhibited the highest surface under the cumulative ranking (SUCRA) value (92.8%) for healing rate. In terms of total adverse events, lansoprazole 30 mg (L30) exhibited the lowest SUCRA value (25.3%) in the treatment of gastric/duodenal ulcers. For the healing rate in erosive esophagitis, the maximum SUCRA value of vonoprazan 40 mg (V40) was 90.7% in the first subgroup (erosive esophagitis using vonoprazan, keverprazan, and lansoprazole) and the maximum SUCRA value of T50 was 72.1% in the second subgroup (erosive esophagitis using tegoprazan, fexuprazan, and esomeprazole). For the total adverse events in erosive esophagitis, L15 exhibited the lowest SUCRA value (12.2%) in the first group and E40 exhibited the lowest SUCRA value (24.4%) in the second group.
K30 may be the most effective dosage for increasing the healing rate of gastric/duodenal ulcers. For erosive esophagitis, V40 and T50 may be the preferred dosages.
钾竞争性酸阻滞剂已成为治疗酸相关疾病的一种有前途的治疗方法。然而，最大化其疗效的最佳剂量仍不清楚。本网络荟萃分析旨在比较各种剂量的钾竞争性酸阻滞剂和质子泵抑制剂治疗酸相关疾病的疗效和安全性。
我们从建库到 2023 年 7 月 16 日在 PubMed、Embase、Cochrane 图书馆和 Web of Science 进行了检索。由 2 名作者独立进行数据提取。使用 Cochrane 偏倚风险评估工具（RoB 2.0）评估偏倚。使用优势比和 95%置信区间比较疗效和安全性。
本荟萃分析纳入了 12 篇文章。对于胃/十二指肠溃疡，Keverprazan 30mg（K30）在愈合率方面表现出最高的累积排序概率（SUCRA）值（92.8%）。在总不良反应方面，兰索拉唑 30mg（L30）在胃/十二指肠溃疡治疗中表现出最低的 SUCRA 值（25.3%）。对于糜烂性食管炎的愈合率，Vonoprazan 40mg（V40）在第一个亚组（使用 Vonoprazan、Keverprazan 和 Lansoprazole 的糜烂性食管炎）中的最大 SUCRA 值为 90.7%，而 T50 在第二个亚组（使用 Tegoprazan、Fexuprazan 和 Esomeprazole 的糜烂性食管炎）中的最大 SUCRA 值为 72.1%。对于糜烂性食管炎的总不良反应，L15 在第一个组中表现出最低的 SUCRA 值（12.2%），E40 在第二个组中表现出最低的 SUCRA 值（24.4%）。
K30 可能是增加胃/十二指肠溃疡愈合率的最有效剂量。对于糜烂性食管炎，V40 和 T50 可能是首选剂量。
