{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T05:14:58Z","timestamp":1783401298596,"version":"3.54.6"},"reference-count":118,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008373","name":"Takeda Pharmaceutical Company","doi-asserted-by":"publisher","award":["none"],"award-info":[{"award-number":["none"]}],"id":[{"id":"10.13039\/100008373","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Eradication rates for\n                      <jats:italic>Helicobacter pylori<\/jats:italic>\n                      (\n                      <jats:italic>H. pylori<\/jats:italic>\n                      ) with proton pump inhibitor (PPI)-based therapy have declined due to rising resistance and pharmacokinetic limitations. Several potassium-competitive acid blockers (PCABs) are now approved for\n                      <jats:italic>H. pylori<\/jats:italic>\n                      eradication. However, direct comparisons among PCABs-based regimens are limited.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>\n                      To evaluate the efficacy, safety and compliance of PCAB-based regimens for\n                      <jats:italic>H. pylori<\/jats:italic>\n                      eradication.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Randomised controlled trials in adults with\n                      <jats:italic>H. pylori<\/jats:italic>\n                      infection, evaluating PCAB-based dual, triple, or bismuth quadruple regimens or comparing PCAB- with PPI-based regimens, were included. The primary outcome was eradication rate; secondary outcomes were compliance and adverse events. Proportional meta-analysis and Bayesian network meta-analysis (NMA) with a random-effects model were conducted to compare efficacy and safety. Pooled estimates were expressed in odd ratio (OR) and corresponding 95% confidence intervals (CIs). Ranking used surface under the cumulative ranking curve (SUCRA). Subgroup analyses were conducted to explore potential sources of heterogeneity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seventy-seven RCTs involving 19,950 patients were included. Vonoprazan (VPZ)-based regimens showed the highest eradication rates in proportional meta-analysis (88.15\u201391.94%), while tegoprazan (TPZ)- and keverprazan (KEV)-based regimens demonstrated more variable performance. NMA demonstrated a significantly higher eradication rate in patients treated with VPZ-based quadruple regimen compared with VPZ-based dual (OR\u00a0=\u00a01.47, 95% CI 1.05\u20132.07) and TPZ-based triple (OR\u00a0=\u00a03.54, 95% CI 1.21\u201310.65) regimen. SUCRA ranking identified VPZ-based quadruple as the highest-ranked regimen (93.78%), followed by VPZ-based triple (70.55%) and TPZ-based quadruple (66.22%) regimen, indicating relative treatment ranking probabilities. Compliance rates were comparable across regimens with no significant differences, while VPZ- and TPZ-based dual therapies showed better safety profiles with lower adverse events than quadruple therapies (OR\u00a0=\u00a00.39\u20130.42).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>VPZ-based quadruple therapy demonstrated the highest eradication efficacy among PCAB-based regimens, with significantly superior performance compared with selected dual and triple therapies. VPZ-based dual therapy appears to have a better balance of efficacy and safety profile. However, as 76 of 77 included trials were conducted in Asian populations, these findings should be interpreted with caution when extrapolating to non-Asian settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/home ID= CRD420251125759<\/jats:ext-link>\n                      identifier CRD420251125759.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphys.2026.1843686","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T04:24:04Z","timestamp":1783398244000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparing potassium-competitive acid blocker-based therapies for Helicobacter pylori infection: A Bayesian network meta-analysis of 77 randomised controlled trials"],"prefix":"10.3389","volume":"17","author":[{"given":"Changmin","family":"Mi","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Peking University Third Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Peking University Third Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyan","family":"Shi","sequence":"additional","affiliation":[{"name":"Research Center of Clinical Epidemiology, Peking University Third Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kailun","family":"Liang","sequence":"additional","affiliation":[{"name":"Takeda Pharmaceutical Company","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Zhou","sequence":"additional","affiliation":[{"name":"Takeda Pharmaceutical Company","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiqiang","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Peking University Third Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1111\/apt.17070","article-title":"Clinical trial: seven-day vonoprazan- versus 14-day proton pump inhibitor-based triple therapy for first-line Helicobacter pylori eradication","volume":"56","author":"Ang","year":"2022","journal-title":"Aliment Pharmacol. 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