Efficacy and Safety of Tegoprazan-Containing Versus Proton Pump Inhibitor-Containing Regimens for First Line Helicobacter pylori Eradication-An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Yang Gao, Jia-Hui Xing, Meng-Meng Fu et al.
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In 30 seconds
This updated systematic review and meta-analysis compared tegoprazan-containing with proton pump inhibitor (PPI)-containing first-line regimens for Helicobacter pylori eradication in treatment-naïve adults. It pooled 11 randomized trials involving 3872 participants and 14 treatment comparisons. In intention-to-treat analyses, eradication success was higher with tegoprazan regimens (85.7% vs. 81.1%; RR = 1.06, 95% CI: 1.03-1.09), although the authors characterized the benefit as small. Evidence was most favorable for 14-day treatment and quadruple therapy; certainty was moderate for eradication and low for adverse events and adherence.
Key findings
- Eradication success was 85.7% with tegoprazan-containing regimens versus 81.1% with PPI-containing regimens (RR = 1.06, 95% CI: 1.03-1.09).
- Subgroup estimates favored tegoprazan for 14-day treatment (RR = 1.07, 95% CI: 1.04-1.11) and quadruple therapy (RR = 1.10, 95% CI: 1.05-1.15).
- Adverse events were reported in 27.1% versus 30.5% (RR = 0.90, 95% CI: 0.82-0.99); evidence certainty was low.
- Adherence was high in both groups, with a small between-group difference and substantial heterogeneity.
Why it matters
Acid suppression is an important component of H. pylori eradication regimens, and this synthesis suggests tegoprazan may modestly improve first-line eradication compared with PPIs. The small pooled difference and limited certainty for safety and adherence mean the findings do not establish a clinically meaningful overall advantage. The results help frame tegoprazan as an alternative under study rather than demonstrating broad superiority.
What to keep in mind
The authors note clinical heterogeneity, geographic limitations, and limited evidence in refractory or special populations. Evidence for adverse events and adherence was low certainty, and adherence results had substantial heterogeneity.