Efficacy of vonoprazan and proton pump inhibitors for mucosal healing failure in initial and maintenance treatment of grade C and D esophagitis
| Risk ratio of treatment failure (95% credible interval)a | SUCRA score | |
|---|---|---|
| Initial treatment | ||
| Compared with vonoprazan 20 mg once daily | 1.0 | 0.89 |
| Keverprazan 20 mg | 0.86 (0.14–4.32) | 0.87 |
| Dexlansoprazole 60 mg | 2.23 (0.97–6.71) | 0.66 |
| Esomeprazole 40 mg | 1.92 (0.84–5.61) | 0.61 |
| Rabeprazole extended release 50 mg | 1.75 (0.64–6.28) | 0.48 |
| Pantoprazole 40 mg | 2.97 (0.94–11.16) | 0.29 |
| Lansoprazole 30 mg | 2.97 (1.64–6.71) | 0.26 |
| Esomeprazole 20 mg | 2.99 (0.93–12.33) | 0.29 |
| Omeprazole 20 mg | 3.5 (1.31–11.79) | 0.15 |
| Maintenance treatment | ||
| Compared with vonoprazan 20 mg once daily | 1.0 | 0.87 |
| Lansoprazole 30 mg | 1.54 (0.24–11.81) | 0.73 |
| Vonoprazan 10 mg | 3.05 (0.35–36.35) | 0.50 |
| Tegoprazan 20 mg | 3.44 (0.12–111.46) | 0.49 |
| Esomeprazole 20 mg | 4.00 (0.23–107.25) | 0.44 |
| Lansoprazole 15 mg | 6.04 (0.88–63.38) | 0.24 |
| Pantoprazole 20 mg | 7.38 (0.21–393.95) | 0.22 |
↵aBold indicates significant differences in treatment failure for lansoprazole 30 mg and omeprazole 20 mg compared with vonoprazan 20 mg in the healing phase; a significant difference in efficacy was not found between vonoprazan and the other proton pump inhibitors.
SUCRA = surface under the cumulative ranking
Adapted with permission from the American College of Gastroenterology. Zhuang Q, Chen S, Zhou X, et al. Comparative efficacy of P-CAB vs proton pump inhibitors for grade C/D esophagitis: a systematic review and network meta-analysis. Am J Gastroenterol 2024; 119(5):803–813. doi:10.14309/ajg.0000000000002714; journals.lww.com/ajg/pages/default.aspx.