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Potassium-competitive acid blockers are safe and effective, especially for 2-week short-term use, severe erosive esophagitis, and maintenance therapy.
A new meta-analysis published in the “Journal of Clinical Gastroenterology” investigated the better therapeutic option between potassium-competitive acid blockers (P-CABs) and proton pump inhibitors (PPIs) for erosive esophagitis (EE) management. Researchers scoured PubMed, Embase, Cochrane Library, and Web of Science for randomized controlled trials up to January 2024, focusing on EE healing rates and adverse events.
In nine trials with 4012 patients, P-CABs showed a superior healing rate over PPIs at 2 weeks [risk ratio (RR) = 1.06]. However, no difference was noted at 4 or 8 weeks. For severe EE (Los Angeles [LA] grade C/D), P-CABs were notably more effective at all time points [at week 2 (RR = 1.17), week 4 (RR = 1.10), or week 8 (RR = 1.08)], but there was no significant difference for patients with LA grade A/B.
P-CABs also had lower recurrence rates during maintenance therapy (RR = 0.79) and fewer headaches (RR = 0.32), with similar rates of other adverse events. P-CABs are safe and more effective choice for treating EE, particularly for short-term relief, severe cases, and long-term maintenance. Despite some trial variability, these findings suggest a strong advantage for P-CABs in managing EE-affected patients.
Journal of Clinical Gastroenterology
Efficacy and Safety of Potassium-competitive Acid Blockers Versus Proton Pump Inhibitors in Treating Erosive Esophagitis: A Meta-analysis Based on Randomized Controlled Trials
Yingying Fang et al.
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