Comparative efficacy and pharmacological heterogeneity of individual potassium-competitive acid blockers: A systematic review and network meta-analysis

doi:10.3748/wjg.121372

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World Journal of Gastroenterology

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1007-9327

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World J Gastroenterol. Oct 21, 2026; 32(39): 121372
Published online Oct 21, 2026. doi: 10.3748/wjg.121372

Table 2 Characteristics of included erosive esophagitis randomized controlled trials (n = 10 studies)

Number	Ref.	Year	Region	P-CAB	PPI	n (overall)	Healing rate in P-CAB group (overall) (n = 2370)	Healing rate in PPI group (overall) (n = 1826)	Healing rate in P-CAB group (LA C/D) (n = 612)	Healing rate in PPI group (LA C/D) (n = 438)
1	Ashida et al[47]	2015	Japan	VPZ 5-40 mg	LPZ 30 mg	686	524/554 (94.6%)	123/132 (93.2%)	184/199 (92.5%)	40/46 (87.0%)
2	Ashida et al[48]	2016	Japan	VPZ 20 mg	LPZ 30 mg	404	203/205 (99.0%)	190/199 (95.5%)	75/75 (100%)	63/72 (87.5%)
3	Xiao et al[49]	2020	China	VPZ 20 mg	LPZ 30 mg	468	220/238 (92.4%)	210/230 (91.3%)	64/76 (84.2%)	55/68 (80.9%)
4	Laine et al[50]	2023	United States/Europe	VPZ 20 mg	LPZ 30 mg	1024	478/514 (92.9%)	431/510 (84.5%)	163/177 (92.1%)	125/174 (71.8%)
5	Chen et al[51]	2022	China	KVP 20 mg	LPZ 30 mg	238	114/119 (95.8%)	107/119 (89.9%)	22/24 (91.7%)	20/25 (80.0%)
6	Oh et al[52]	2025	South Korea	ZPZ 20 mg	ESO 40 mg	282	141/144 (97.9%)	131/138 (94.9%)	6/6 (100%)	5/6 (83.3%)
7	Lee et al[53]	2022	South Korea	FXP 40 mg	ESO 40 mg	218	106/107 (99.1%)	110/111 (99.1%)	NR	NR
8	Zhuang et al[54]	2024	China	FXP 40 mg	ESO 40 mg	328	146/165 (88.5%)	145/163 (89.0%)	41/51 (80.4%)	43/47 (91.5%)
9	Lee et al[55]	2019	South Korea	TPZ 50/100 mg	ESO 40 mg	300	192/201 (98.5%)	92/99 (92.9%)	~4/4 (100%)	NR
10	Zhu et al[56]	2025	China	TPZ 50 mg	ESO 40 mg	248	112/123 (91.1%)	116/125 (92.8%)	NR	NR

Los Angeles classification C/D data summary by potassium-competitive acid blocker: (1) Zastaprazan [acid dissociation constant (pKa) of 995]: 100% vs 83.3% (+16.7%, n = 6/arm); (2) Keverprazan (pKa of 912): 91.7% vs 80.0% (+11.7%, n = 24-25/arm); (3) Vonoprazan (pKa of 906): 84.0%-100% vs 71.8%-86.7% (pooled +13.4%); (4) Fexuprazan (pKa of 904): 80% vs 91% (-11%, inferior to proton pump inhibitor despite high-pKa); and (5) Tegoprazan (pKa of 51): 100% vs not reported (data limited). P-CAB: Potassium-competitive acid blocker; PPI: Proton pump inhibitor; VPZ: Vonoprazan; TPZ: Tegoprazan; KVP: Keverprazan; FXP: Fexuprazan; ZPZ: Zastaprazan; LPZ: Lansoprazole; ESO: Esomeprazole; NR: Not reported; LA: Los Angeles classification.

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Citation: Gong EJ, Bang CS, Lee JJ, Baik GH. Comparative efficacy and pharmacological heterogeneity of individual potassium-competitive acid blockers: A systematic review and network meta-analysis. World J Gastroenterol 2026; 32(39): 121372
URL: https://www.wjgnet.com/1007-9327/full/v32/i39/121372.htm
DOI: https://dx.doi.org/10.3748/wjg.121372

Gong EJ, Bang CS, Lee JJ, Baik GH. Comparative efficacy and pharmacological heterogeneity of individual potassium-competitive acid blockers: A systematic review and network meta-analysis. World J Gastroenterol 2026; 32(39): 121372 [DOI: 10.3748/wjg.121372]

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