Your browser doesn't support javascript.
loading
Treatment Response With Potassium-competitive Acid Blockers Based on Clinical Phenotypes of Gastroesophageal Reflux Disease: A Systematic Literature Review and Meta-analysis.
Seo, Seungyeon; Jung, Hye-Kyung; Gyawali, C Prakash; Lee, Hye Ah; Lim, Hyung Seok; Jeong, Eui Sun; Kim, Seong Eun; Moon, Chang Mo.
Afiliación
  • Seo S; Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea.
  • Jung HK; Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea.
  • Gyawali CP; Division of Gastroenterology, Washington University School of Medicine, St. Louis, MO, USA.
  • Lee HA; Clinical Trial Center, Mokdong Hospital, Ewha Womans University, Seoul, Korea.
  • Lim HS; Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea.
  • Jeong ES; Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea.
  • Kim SE; Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea.
  • Moon CM; Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea.
J Neurogastroenterol Motil ; 30(3): 259-271, 2024 Jul 30.
Article en En | MEDLINE | ID: mdl-38972863
ABSTRACT
Background/

Aims:

Gastroesophageal reflux disease (GERD) is typically managed based on the clinical phenotype. We evaluated the efficacy and safety of potassium-competitive acid blockers (PCABs) in patients with various clinical GERD phenotypes.

Methods:

Core databases were searched for studies comparing PCABs and proton pump inhibitors (PPIs) in clinical GERD phenotypes of erosive reflux disease (ERD), non-erosive reflux disease (NERD), PPI-resistant GERD and night-time heartburn. Additional analysis was performed based on disease severity and drug dosage, and pooled efficacy was calculated.

Results:

In 9 randomized controlled trials (RCTs) evaluating the initial treatment of ERD, the risk ratio for healing with PCABs versus PPIs was 1.09 (95% CI, 1.04-1.13) at 2 weeks and 1.03 (95% CI, 1.00-1.07) at 8 weeks, respectively. PCABs exhibited a significant increase in both initial and sustained healing of ERD compared to PPIs in RCTs, driven particularly in severe ERD (Los Angeles grade C/D). In 3 NERD RCTs, PCAB was superior to placebo in proportion of days without heartburn. Observational studies on PPI-resistant symptomatic GERD reported symptom frequency improvement in 86.3% of patients, while 90.7% showed improvement in PPIresistant ERD across 5 observational studies. Two RCTs for night-time heartburn had different endpoints, limiting meta-analysis. Pronounced hypergastrinemia was observed in patients treated with PCABs.

Conclusions:

Compared to PPIs, PCABs have superior efficacy and faster therapeutic effect in the initial and maintenance therapy of ERD, particularly severe ERD. While PCABs may be an alternative treatment option in NERD and PPI-resistant GERD, findings were inconclusive in patients with night-time heartburn.
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Neurogastroenterol Motil Año: 2024 Tipo del documento: Article Pais de publicación: Corea del Sur
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Neurogastroenterol Motil Año: 2024 Tipo del documento: Article Pais de publicación: Corea del Sur