The following is a summary of “Efficacy and Safety of Potassium-competitive Acid Blockers Versus Proton Pump Inhibitors in Treating Erosive Esophagitis: A Meta-analysis Based on Randomized Controlled Trials,” published in the July 2024 issue of Gastroenterology by Fang et al.
Researchers conducted a retrospective study comparing the efficacy and safety of potassium-competitive acid blockers (P-CABs) vs. proton pump inhibitors (PPIs) in treating erosive esophagitis (EE).
They systematically searched PubMed, Embase, Cochrane Library, and Web of Science using predefined search terms (January 2024), and relevant RCTs were selected. The outcomes measured included the healing rate of EE and the incidence of treatment-related AEs.
The results showed 9 RCTs involving 4,012 patients. The patients treated with P-CAB had a significantly higher overall healing rate than PPI at week 2 [risk ratio (RR) = 1.06], but no significant differences were noted at weeks 4 and 8. Subgroup analysis indicated that P-CAB achieved a greater healing rate for patients with Los Angeles (LA) grade C/D, with assessments showing RR values of 1.17 at week 2, 1.10 at week 4, and 1.08 at week 8. No significant differences were observed between PPI and P-CAB for patients with LA grade A/B at any time. Additionally, patients on P-CAB experienced lower recurrence rates during maintenance therapy than those on PPI (RR = 0.79). Regarding safety, P-CAB was linked to a reduced incidence of headache compared to PPI (RR = 0.32), with no significant differences in other treatment-related adverse events between the 2 groups.
Investigators concluded that P-CABs demonstrated superior efficacy and safety to PPIs in treating erosive esophagitis, especially in short-term, severe, and maintenance treatment.
Source: journals.lww.com/jcge/abstract/9900/efficacy_and_safety_of_potassium_competitive_acid.332.aspx
