Tegoprazan vs. proton pump inhibitors for erosive esophagitis: a superior alternative or just another option? A systematic review and meta-analysis of randomized controlled trials

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Tegoprazan vs. proton pump inhibitors for erosive esophagitis: a superior alternative or just another option? A systematic review and meta-analysis of randomized controlled trials

Nayyer et al., 2025 | Eur J Gastroenterol Hepatol | Meta Analysis

Citation

Nayyer Muhammad Anas, Rasool Hamna, ... Umer Mohammad. Tegoprazan vs. proton pump inhibitors for erosive esophagitis: a superior alternative or just another option? A systematic review and meta-analysis of randomized controlled trials. Eur J Gastroenterol Hepatol. 2025-Dec-01;37(12):e1-e7. doi:10.1097/MEG.0000000000003030

Abstract

Tegoprazan, a novel potassium-competitive acid blocker, has emerged as a potential alternative to proton pump inhibitors (PPIs) for the treatment of erosive esophagitis (EE), especially in light of long-term safety concerns associated with PPIs. This study aimed to assess the efficacy and safety of tegoprazan compared to PPIs in patients with EE. A systematic review and meta-analysis were conducted following preferred reporting items for systematic reviews and meta-analyses guidelines, including three randomized controlled trials with a total of 658 patients diagnosed with EE. The primary outcomes were cumulative endoscopic healing rates across 4-8 weeks and at 4 and 8 weeks, while secondary outcomes included any adverse events, drug-related treatment-emergent adverse events (TEAEs), and serious adverse events (SAEs). Tegoprazan demonstrated noninferior healing rates at 4 weeks [relative risk (RR) = 1.05, 95% confidence interval (CI): 0.96-1.16; P  = 0.28; I ² = 51%] and 8 weeks (RR = 1.01, 95% CI: 0.96-1.06; P  = 0.73; I ² = 0%) compared to PPIs. There was no statistically significant difference in the overall incidence of adverse events or SAEs (RR = 1.19, 95% CI: 0.92-1.53; P  = 0.19; I ² = 24%). However, a significantly higher rate of drug-related TEAEs was observed in the tegoprazan group (RR = 1.23, 95% CI: 1.03-1.48; P  = 0.02; I ² = 0%). In conclusion, tegoprazan is an effective treatment option for EE, with comparable efficacy to PPIs, though further studies are warranted to evaluate its long-term safety before routine clinical use.

Key Findings

In conclusion, tegoprazan is an effective treatment option for EE, with comparable efficacy to PPIs, though further studies are warranted to evaluate its long-term safety before routine clinical use.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population ee
Sample Size 658
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Proton Pump Inhibitors
  • Randomized Controlled Trials as Topic
  • Treatment Outcome
  • Esophagitis, Peptic
  • Esophagitis
  • Esophagoscopy
  • Pyrroles
  • Sulfonamides

Evidence Classification

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

Provenance

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