Comparison of tegoprazan and proton pump inhibitors for first-line <i>Helicobacter pylori</i> eradication: a systematic review with meta-analysis

Tegoprazan (TPZ), a potassium-competitive acid blocker with potent gastric acid-suppressing activity, may be a potential agent for treating <i>Helicobacter pylori</i> infection. The study aimed to evaluate the efficacy of TPZ-based therapy for <i>H. pylori</i> eradication compared with proton pump inhibitor (PPI)-based therapy. A comprehensive literature search was conducted up to August 2024 using PubMed, Embase, and the Cochrane Library to investigate the beneficial effects of TPZ-based therapy for <i>H. pylori</i> eradication. Studies that evaluated the eradication rates between the TPZ- and PPI-based therapies were included. The authors conducted a meta-analysis to calculate the eradication rate and pooled risk ratio (RR) with a 95% confidence interval. Seven studies involving 3200 patients were included. <i>H. pylori</i> eradication rates did not differ significantly between the TPZ- and PPI-based therapies based on the intention-to-treat (77.3% vs. 76.4%, <i>p</i> = 0.68; pooled RR = 1.01 [0.97–1.05]) and per-protocol (84.3% vs. 84.2%, <i>p</i> = 0.69; pooled RR = 1.01 [0.98–1.04]) analyses. Additionally, no significant difference was observed in the adverse drug events between TPZ- and PPI-based therapies (27.2% vs. 30.8%, <i>p</i> = 0.26; pooled RR = 0.91 [0.76–1.08]). <i>H. pylori</i> eradication and adverse drug event rates with TPZ- and PPI-based treatments were similar.