METHODS: A thorough search was conducted across databases. The primary outcome was to determine the mean variance in the gastroesophageal reflux disease (GERD) score after vonoprazan treatment. Secondary outcomes comprised alterations in the scores for epigastric pain and post-prandial distress, the proportion of patients displaying improvement, and the occurrence of adverse events. Pooled mean differences and relative risks were determined utilizing random effects models.
RESULTS: A total of 1,944 articles were screened and nine of them were included. As compared to PPI or no vonoprazan therapy, vonoprazan treatment led to a significant reduction in the GERD score [mean difference: -3.88 (95 % CI: -5.48, -2.28), p < 0.01, i2=95 %]. As compared to PPI or no vonoprazan therapy, vonoprazan treatment led to a significant reduction in the epigastric pain score [mean difference: -3.02 (95 % CI: -5.41, -0.63), p = 0.01, i2=75 %] and post-prandial distress score [mean difference: -2.82 (95 % CI: -3.51, -2.12), p < 0.01, i2=0 %] (all moderate GRADE evidence). Vonoprazan therapy was found to be safe.
CONCLUSIONS: Treatment with vonoprazan could significantly improve symptoms in patients with non-erosive esophagitis or non-erosive GERD.
方法:在数据库中进行了彻底的搜索。主要结果是确定vonoprazan治疗后胃食管反流病(GERD)评分的平均方差。次要结果包括上腹痛和餐后窘迫评分的改变,显示改善的患者比例,以及不良事件的发生。利用随机效应模型确定集合均值差异和相对风险。
结果:共筛选了1,944篇文章,其中9篇被纳入。与PPI或不使用vonoprazan治疗相比,vonoprazan治疗导致GERD评分显着降低[平均差异:-3.88(95%CI:-5.48,-2.28),p<0.01,i2=95%]。与PPI或不使用vonoprazan治疗相比,vonoprazan治疗导致上腹痛评分显着降低[平均差异:-3.02(95%CI:-5.41,-0.63),p=0.01,i2=75%]和餐后痛苦评分[平均差:-2.82(95%CI:-3.51,-2.12),p<0.01,i2=0%](所有中等等级证据)。沃诺拉赞治疗被认为是安全的。
结论:沃诺拉赞治疗可显著改善非糜烂性食管炎或非糜烂性GERD患者的症状。