Umbrella review analysis of the safety and efficacy of vonoprazan in the treatment of peptic ulcers and post-ESD ulcers
- VernacularTitle:伏诺拉生治疗消化性溃疡和ESD术后溃疡安全性和有效性的伞形评价
- Author:
Qingmei ZHU
1
;
Min SHI
2
;
Dongliang YANG
1
;
Haixia ZHAO
1
Author Information
1. Xinjiang Key Laboratory of Clinical Drug Research，the First Affiliated Hospital of Xinjiang Medical University，Urumqi 830054，China
2. School of Basic Medicine and Clinical Pharmacy，China Pharmaceutical University，Nanjing 211198，China
- Publication Type:Journal Article
- Keywords:
vonoprazan;
peptic ulcer;
post-endoscopic submucosal dissection ulcers;
meta-analysis;
umbrella review;
safety
- From:
China Pharmacy
2026;37(3):389-394
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To analyze the safety and efficacy of vonoprazan （VPZ） in the treatment of peptic ulcer （PU） and post-endoscopic submucosal dissection （ESD） ulcers， providing evidence-based pharmaceutical evidence for clinical practice and medical decision-making. METHODS Retrieved from CNKI， Wanfang， VIP， CBM， PubMed， Embase， Web of Science， and the Cochrane Library， meta-analyses/systematic reviews related to VPZ in the treatment of PU and post-ESD ulcers were collected. Two researchers independently performed literature screening， data extraction， quality assessment of included studies， and evaluation of literature overlap. By employing the umbrella review analysis， a fresh meta-analysis was conducted on all relevant raw research data when a high degree of overlap was identified among the included studies. RESULTS A total of 17 meta-analyses were included， with quality ranging from high to very low； all outcome measures involved showed a very high level of overlap in the included meta-analyses （corrected covered area： 22.22%-100%）. In the treatment of post-ESD ulcers， compared to proton pump inhibitor （PPI）， VPZ significantly improved the ulcer healing rate at 4 weeks post-ESD [RR＝1.27， 95%CI （1.03， 1.56）， Z＝2.21， P＝ 0.027] and the ulcer contraction rate post-ESD [MD＝0.08， 95%CI （0.00， 0.16）， Z＝2.09， P＝0.037]， while significantly reducing the ulcer recurrence rate in patients with a history of PU [RR＝0.49， 95%CI （0.32， 0.73）， Z＝3.49， P＝0.001]； the delayed bleeding rate in the VPZ group was significantly lower than that in the lansoprazole subgroup [RR＝0.47， 95%CI （0.25， 0.90）， Z＝2.28， P＝0.02]. In the treatment of PU， the incidence of adverse events with VPZ was significantly higher than that with PPI in the duodenal ulcer subgroup [RR＝1.13， 95%CI （1.02， 1.26）， Z＝2.38， P＝0.017]. CONCLUSIONS For post-ESD ulcers， VPZ demonstrates superior therapeutic efficacy compared to PPI and can reduce ulcer recurrence rates in patients with a history of PU. However， it does not offer advantages in terms of safety for duodenal ulcer treatment.
