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Tegoprazan delivers faster acid suppression and superior nocturnal symptom control with non-inferior healing versus PPIs in GERD.
A large study has positioned tegoprazan, a potassium-competitive acid blocker (PCAB), as a next-generation therapy for gastroesophageal reflux disease (GERD)—delivering prompt acid suppression, superior nocturnal symptom control, and non-inferior healing compared with proton pump inhibitors (PPIs).
The systematic review and meta-analysis included 18 randomized controlled trials (2015–2026) identified from PubMed, Cochrane, Wiley, and ClinicalTrials.gov, evaluating tegoprazan versus PPIs in adults with GERD and related acid-mediated conditions. In erosive esophagitis sufferers, tegoprazan 50 mg once daily attained mucosal healing rates closely matching PPIs and confirming non-inferiority. Notably, tegoprazan offered faster nighttime symptom relief along with a higher percentage of heartburn-free nights. Both complete (p = 0.038) and partial (p = 0.034) nocturnal symptom resolution were remarkably improved (Table 1).
Beyond healing, tegoprazan illustrated rapid pharmacodynamic action, attaining intragastric pH ≥4 within 30–60 minutes and maintaining acid control for up to 12 hours, translating into improved clinical outcomes. In NERD, symptom resolution ranged from 42.5% to 48.9%, compared with 24.2% for placebo, while open-label studies in functional dyspepsia reported improvement rates between 74.6% and 86.7%. Additionally, pooled data from seven trials (n = 2492) depicted a modest but substantial rise in Helicobacter pylori (H. pylori) elimination with tegoprazan-based regimens (RR = 1.05; I² = 0%).
Across studies, adverse events were mild and similar to PPIs, supporting a favorable safety profile. Tegoprazan combines rapid onset, sustained acid suppression, and superior nocturnal symptom control, addressing key limitations of PPIs. Its consistent efficacy, independent of CYP2C19 metabolism, makes it especially valuable in those with refractory GERD or variable drug response.
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Tegoprazan in Gastroesophageal Reflux Disease and Related Acid‐Mediated Conditions: A Systematic Review and Meta‐Analysis
Sanjay Bandyopadhyay et al.
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