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Proton pump inhibitors (PPIs) are extensively prescribed acid-suppressing agents used to relieve symptoms such as heartburn and acid reflux.
Tegoprazan is associated with a reduced risk of liver injury when compared with traditional proton pump inhibitors.
Proton pump inhibitors (PPIs) are extensively prescribed acid-suppressing agents used to relieve symptoms such as heartburn and acid reflux. Recently, potassium-competitive acid blockers (P-CABs)—notably tegoprazan—have emerged as alternative treatments that also suppress gastric acid secretion. Using real-world data, this population-based study explored the risk of hepatotoxicity associated with 6 commonly used PPIs and tegoprazan.
Conducted between January 2019 and December 2020, the study analyzed health data from approximately 50 million individuals in South Korea. Using propensity score matching with 10 baseline variables, researchers compared the incidence of hepatotoxicity between tegoprazan and 6 PPIs (dexlansoprazole, esomeprazole, lansoprazole, omeprazole, pantoprazole, and rabeprazole). The key endpoint was hepatotoxicity, defined as toxic liver disease, liver transplantation, hepatitis, hepatic failure, or other liver-related conditions.
In this retrospective cohort study, tegoprazan illustrated a substantially lower likelihood of hepatotoxicity compared to most PPIs. The risk ratios (RRs) along with confidence intervals (CIs) for tegoprazan versus the 6 PPIs were as follows:
When compared collectively, tegoprazan showed an overall RR of 0.73 (95% CI 0.72–0.75) versus the 6 PPIs. The hazard ratios (HRs) of hepatotoxicity were higher for all PPIs except omeprazole (HR: dexlansoprazole = 1.13; esomeprazole = 1.04; lansoprazole = 1.25; omeprazole = 0.77; pantoprazole = 1.26; rabeprazole = 1.15; combined PPIs = 1.10).
Based on the nationwide cohort of 50 million Korean patients, tegoprazan was not associated with an increased risk of hepatotoxicity when compared with 6 traditional PPIs. Thus, tegoprazan may offer a safer alternative for acid suppression, particularly for those at risk of liver-related side effects.
Frontiers in Medicine
Comparison of hepatotoxicity of tegoprazan, a novel potassium-competitive acid blocker, with proton pump inhibitors using real-world data: A nationwide cohort study
Min-Gul Kim et al.
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