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Pantoprazole and Vonoprazan Performed Well in Preventing Peptic Ulcer Recurrence in Low-Dose Aspirin Users

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Abstract

Background

Low-dose aspirin (LDA) administration is associated with an elevated risk of recurring peptic ulcer (PU) and gastrointestinal (GI) hemorrhage.

Aims

This systematic review and Bayesian network meta-analysis aimed to comprehensively assess the effectiveness of diverse medications in preventing the recurrence of PU and GI hemorrhage in patients with a history of PU receiving long-term LDA therapy.

Methods

This systematic review and network meta-analysis followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and was registered on PROSPERO (CRD42023406550). We searched relevant studies in main databases from inception to March 2023. All statistical analyses were performed using R (version 4.1.3), with the “Gemtc” (version 1.0-1) package. The pooled risk ratio (RR), corresponding 95% credible interval (95% CrI), and the surface under the cumulative ranking curve (SUCRA) were calculated.

Results

11 Randomized clinical trials (RCTs) were included. The analysis underscored pantoprazole was the most efficacious for reducing the risk of PU recurrence (RR [95% CrI] = 0.02 [0, 0.28]; SUCRA: 90.76%), followed by vonoprazan (RR [95% CrI] = 0.03 [0, 0.19]; SUCRA: 86.47%), comparing with the placebo group. Pantoprazole also performed well in preventing GI hemorrhage (RR [95% CrI] = 0.01[0, 0.42]; SUCRA: 87.12%) compared with Teprenone.

Conclusions

For patients with a history of PU receiving LDA, pantoprazole and vonoprazan might be the optimal choices to prevent PU recurrence and GI hemorrhage.

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Data availability

Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.

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Acknowledgments

We would like to express our appreciation for the technical assistance provided by the Chinese University of Hong Kong and SUN YAT-SEN UNIVERSITY. However, there is no grant allocated for this research work.

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Authors and Affiliations

  1. School of Medicine, The Chinese University of Hong Kong, Shatin, NT, 999077, Hong Kong

    Haoyu An

  2. Zhongshan School of Medicine, Sun Yat‐Sen University, Guangzhou, 510080, Guangdong, China

    Jing Chen

  3. School of Life Science, Central South University, Changsha, 410008, Hunan, China

    Shicong Li

  4. NYU School of Global Public Health, New York University, New York, NY, 10003, USA

    Anni Chen

  5. Prince of Wales Hospital, 30 Yincheng Street, Shatin, Hong Kong

    Haoyu An

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Contributions

Conceptualization: HA; Methodology: HA, JC; Formal analysis and investigation: HA, JC, SL; Writing—original draft preparation: HA, JC, AC; Writing—review and editing: HA, SL; Resources: HA, SL; Supervision: HA, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Haoyu An.

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An, H., Chen, J., Li, S. et al. Pantoprazole and Vonoprazan Performed Well in Preventing Peptic Ulcer Recurrence in Low-Dose Aspirin Users. Dig Dis Sci 69, 670–682 (2024). https://doi.org/10.1007/s10620-023-08233-4

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