Vonoprazan versus proton-pump inhibitors for healing gastroesophageal reflux disease: A systematic review

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#bayes-theorem #esophagitis-peptic #gastroesophageal-reflux #humans #patient-selection

Vonoprazan versus proton-pump inhibitors for healing gastroesophageal reflux disease: A systematic review

Miyazaki et al., 2019 | J Gastroenterol Hepatol | Systematic Review

Citation

Miyazaki Hirota, Igarashi Ataru, ... Tango Toshiro. Vonoprazan versus proton-pump inhibitors for healing gastroesophageal reflux disease: A systematic review. J Gastroenterol Hepatol. 2019-Aug;34(8):1316-1328. doi:10.1111/jgh.14664

Abstract

BACKGROUND AND AIM: Gastroesophageal reflux disease (GERD) is a common disease caused by reflux of gastric contents to the esophagus. Proton-pump inhibitors (PPIs) are recommended as a first-line therapy to treat GERD. Recently, a new potassium-competitive acid blocker, vonoprazan, was launched in Japan. We aimed to evaluate the comparative efficacy of vonoprazan and other PPIs in healing GERD. METHODS: We used MEDLINE and the Cochrane Central Register of Controlled Trials to search the literature. Double-blind randomized controlled trials for PPIs and/or vonoprazan that were published in English or Japanese and assessed healing effects in adult GERD patients were included. To estimate the comparative efficacy of treatments, we performed a Bayesian network meta-analysis to assess the consistency assumption. RESULTS: Of 4001 articles identified in the database, 42 studies were eligible. One study was hand-searched and added to the analysis. For the main analysis of healing effects at 8 weeks, odds ratios (ORs) of vonoprazan (20 mg daily) to esomeprazole (20 mg), rabeprazole (20 mg), lansoprazole (30 mg), and omeprazole (20 mg) were 2.29 (95% credible interval, 0.79-7.06), 3.94 (1.15-14.03), 2.40 (0.90-6.77), and 2.71 (0.98-7.90), respectively. Subgroup analysis for patients with severe esophagitis at baseline showed significantly higher ORs for vonoprazan versus most of the comparator PPIs. CONCLUSIONS: This analysis shows that the GERD healing effect of vonoprazan is higher than that of rabeprazole (20 mg) but not higher than other PPIs. Subgroup analysis indicated that vonoprazan is more effective than most PPIs for patients with severe erosive esophagitis.

Key Findings

Of 4001 articles identified in the database, 42 studies were eligible. One study was hand-searched and added to the analysis. For the main analysis of healing effects at 8 weeks, odds ratios (ORs) of vonoprazan (20 mg daily) to esomeprazole (20 mg), rabeprazole (20 mg), lansoprazole (30 mg), and omeprazole (20 mg) were 2.29 (95% credible interval, 0.79-7.06), 3.94 (1.15-14.03), 2.40 (0.90-6.77), and 2.71 (0.98-7.90), respectively. Subgroup analysis for patients with severe esophagitis at baselin

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population adult gerd
Sample Size 42
Age Range See abstract
Condition See abstract

MeSH Terms

  • Bayes Theorem
  • Esophagitis, Peptic
  • Gastroesophageal Reflux
  • Humans
  • Patient Selection
  • Proton Pump Inhibitors
  • Pyrroles
  • Randomized Controlled Trials as Topic
  • Remission Induction
  • Severity of Illness Index
  • Sulfonamides
  • Time Factors
  • Treatment Outcome
  • Wound Healing

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Journal Article, Systematic Review, Network Meta-Analysis
  • Vertical: potassium

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09