P2797 - Comparative Efficacy and Safety of Tegoprazan vs Proton Pump Inhibitors for Erosive Esophagitis: A Meta-Analysis of Randomized Controlled Trials

Muhammad Imaz Bhatti, MBBS¹, Muhammad Safiullah, MBBS¹, Muhammad Faiq Akram, MBBS², Azka Ijaz, MBBS¹, Qasim Mehmood, MBBS¹, Ishmal Fatima Shahid, MBBS¹, Maha Sajjad, MBBS¹
1King Edward Medical University, Lahore, Lahore, Punjab, Pakistan; 2Allama Iqbal Medical College, Lahore, Lahore, Punjab, Pakistan

Introduction: Proton pump inhibitors (PPIs) remain the standard treatment option for erosive esophagitis (EE) but have notable limitations due to side effects associated with long-term use. Tegoprazan, a potassium-competitive acid suppressant (P-CAB), may provide an alternative treatment option. In this study, we aim to evaluate the healing rates of erosive esophagitis using tegoprazan versus PPIs, along with their safety profiles.

Methods: A comprehensive literature search was conducted in PubMed, Embase, and ClinicalTrials.gov through March 2025. Risk of bias was evaluated using the Cochrane RoB 2.0 tool. Pooled estimates were calculated using random-effects models in Review Manager 5.4.

Results: Four RCTs encompassing a total of 812 patients were included in the analysis. Tegoprazan demonstrated similar healing rates to PPIs at both 4 weeks (RR 1.05, 95% CI: 0.99–1.11; p=0.12) and 8 weeks (RR 1.02, 95% CI: 0.98–1.06; p=0.35). Subgroup analyses by dose (50 mg and 100 mg) showed no significant differences. While tegoprazan was associated with a slightly higher incidence of overall adverse events (61.8% vs. 51.9%; RR 1.18, 95% CI: 0.99–1.40; p=0.07), it had a lower incidence of headache (1.3% vs. 4.2%; RR 0.40, 95% CI: 0.08–2.00).

Discussion: Tegoprazan is non-inferior to PPIs in treating EE, demonstrating comparable efficacy and tolerability. It may serve as an effective alternative for patients experiencing side effects from PPI use. Further large-scale, long-term studies are warranted to validate these findings and assess patient-centered outcomes.


Figure: Figure 1: Forest plot showing: (a) healing rates between Tegoprazan and PPIs at 4 and 8 weeks; (b) healing rates between Tegoprazan 50 mg or 100 mg and PPIs.

Disclosures:
Muhammad Imaz Bhatti indicated no relevant financial relationships.
Muhammad Safiullah indicated no relevant financial relationships.
Muhammad Faiq Akram indicated no relevant financial relationships.
Azka Ijaz indicated no relevant financial relationships.
Qasim Mehmood indicated no relevant financial relationships.
Ishmal Fatima Shahid indicated no relevant financial relationships.
Maha Sajjad indicated no relevant financial relationships.

Muhammad Imaz Bhatti, MBBS¹, Muhammad Safiullah, MBBS¹, Muhammad Faiq Akram, MBBS², Azka Ijaz, MBBS¹, Qasim Mehmood, MBBS¹, Ishmal Fatima Shahid, MBBS¹, Maha Sajjad, MBBS¹. P2797 - Comparative Efficacy and Safety of Tegoprazan vs Proton Pump Inhibitors for Erosive Esophagitis: A Meta-Analysis of Randomized Controlled Trials, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.