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Tegoprazan is as effective and safe as PPIs for treating erosive esophagitis, with consistent efficacy regardless of CYP2C19 genotype.
A systematic review and meta-analysis has revealed that tegoprazan, a novel potassium-competitive acid blocker (P-CAB), is as effective and safe as traditional proton pump inhibitors (PPIs) in relieving erosive esophagitis (EE). The study analyzed data from 4 randomized controlled trials involving 963 patients with endoscopically confirmed EE, comparing tegoprazan directly with various PPIs.
Helai Hussaini and other researchers carried out a comprehensive literature search across multiple databases, focusing on studies that investigated healing rates and safety outcomes. Meta-analysis showed no prominent difference in healing rates between tegoprazan and PPIs overall (risk ratio [RR]: 1.03). The results were consistent at both 4 weeks (RR: 1.05) and 8 weeks (RR: 1.01).
In terms of safety, tegoprazan illustrated a profile comparable to PPIs. Rates of treatment-emergent adverse events (RR: 0.93), drug-related adverse events (RR: 0.93), and serious adverse events (RR: 1.07) did not considerably differ between the groups. Symptom relief was also similar across all the included studies. Importantly, tegoprazan maintained consistent efficacy regardless of CYP2C19 genotype, a key metabolic pathway affecting the response to many PPIs. This may yield a therapeutic edge in populations with genetic variability in PPI metabolism.
However, the authors noted several limitations. Most patients enrolled had mild-to-moderate disease (Los Angeles classification grades A and B), leaving uncertainty about the drug’s usefulness in more severe cases. Additionally, the trials were largely conducted in Asian populations, and follow-up durations were relatively short. Despite these limitations, this analysis is the first to directly compare tegoprazan with PPIs in EE, and it supports tegoprazan as a viable alternative in clinical practice. The findings highlight the requisition for further trials evaluating long-term outcomes and broader population groups.
Cureus
Comparative Efficacy and Safety of Tegoprazan Versus Proton Pump Inhibitors for Erosive Esophagitis: A Systematic Review and Meta-Analysis
Helai Hussaini et al.
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