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KMID : 0370220220660060374
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Yakhak Hoeji
2022 Volume.66 No. 6 p.374 ~ p.382
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The Efficacy of Potassium Competitive Acid Blocker-based First-line Triple Therapy on Helicobacter pylori Eradication as Compared to Proton Pump Inhibitor-based Treatment: A Systematic Review and Meta-analysis
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Kim Mi-Ryoung
Han So-La
Suh Hae-Sun
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Abstract
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Although randomized controlled trials (RCTs) comparing potassium competitive acid blockers (PCABs) andproton-pump inhibitors (PPIs) have been previously conducted, systematic reviews are lacking. In this systematic reviewand meta-analysis, we searched the CENTRAL, EMBASE, MEDLINE, KMBASE, and KoreaMed databases for relevantRCTs up to October 3, 2020. We assessed the Helicobacter pylori eradication rate of PCAB-based first-line triple therapyand compared it with that of PPI-based therapy. In all five of the included studies comprising a total of 1542 patients, theintervention used was vonoprazan (VPZ)-based therapy, and there were no studies on tegoprazan (TPZ)-based therapy. Thepooled risk ratios (RRs) for the eradication rate of VPZ-based therapy as compared to those of PPI-based therapies was1.17 (95% confidence interval (CI): 1.10?1.26, P<0.00001 for overall effect, I2=41%, P=0.15 for heterogeneity). The RRof VPZ-based therapy compared to that of PPI-based for clarithromycin (CAM)-resistant strains was 1.29 (95% CI: 1.12?1.48, P<0.0003 for overall effect, I2=0%, P=0.78 for heterogeneity). VPZ-based first-line triple therapy shows a significantH. pylori eradication rate compared to that of the PPI-based. Notably, VPZ-based therapy shows a better eradication ratethan that PPI-based therapy, even in patients with CAM-resistant strains.
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KEYWORD
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Helicobacter pylor, , Disease Eradication, Gastric Disease, Proton Pump Inhibitors
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