Clinical and Translational Research
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 6, 2024; 12(19): 3890-3897
Published online Jul 6, 2024. doi: 10.12998/wjcc.v12.i19.3890
Efficacy of fexuprazan compared with rebamipide in Korean patients with gastritis: A matching-adjusted indirect comparison
Gwang Ha Kim, Hang Lak Lee
Gwang Ha Kim, Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
Hang Lak Lee, Department of Internal Medicine, Hanyang University College of Medicine, Seoul 04763, South Korea
Author contributions: Kim GH conceived and designed the study; Kim GH and Lee HL collected data and performed data analysis; Kim GH and Lee HL wrote the draft of this manuscript; Kim GH edited the manuscript.
Conflict-of-interest statement: All authors declare no conflicts of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gwang Ha Kim, MD, PhD, Professor, Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan 49241, South Korea. doc0224@pusan.ac.kr
Received: March 18, 2024
Revised: May 3, 2024
Accepted: May 22, 2024
Published online: July 6, 2024
Processing time: 103 Days and 4.8 Hours
Abstract
BACKGROUND

Gastritis is one of the most frequently diagnosed diseases requiring medical treatment in South Korea. Fexuprazan, a novel potassium-competitive acid blocker, has been approved for treating gastritis and erosive esophagitis. Meanwhile, rebamipide is the most commonly used mucoprotective agent for acute and chronic gastritis in real-world settings in South Korea. However, there have been no studies comparing the efficacy of these two drugs yet.

AIM

To compare the efficacy of fexuprazan with that of rebamipide for acute and chronic gastritis.

METHODS

This was a matching-adjusted indirect comparison. Individual patient data from a phase III study of fexuprazan (10 mg BID) were compared with cumulative data from two matching studies of rebamipide (100 mg TID). Erosion improvement and healing rates were compared between two weeks of fexurapan, two weeks of rebamipide, and four weeks of rebamipide. The two main outcome variables were presented as percentages, and the risk differences (RD) and 95% confidence intervals (CI) were calculated for the relative treatment effects.

RESULTS

In the primary analysis, the erosion improvement and healing rates after a two-week treatment with fexuprazan were 64.5% and 53.2%, respectively, while a two-week treatment with rebamipide resulted in erosion improvement and healing rates of 43.6% (RD: 21.0%; 95%CI: 9.6-32.3; P < 0.01) and 35.6% (RD: 17.6%; 95%CI: 6.1-29.2; P = 0.003), respectively. In the additional analysis, the erosion improvement and healing rates for the two-week fexuprazan treatment (64.2% and 51.2%, respectively) were similar to those obtained during a four-week treatment with rebamipide (60.6%; RD: 3.6%; 95%CI: -9.8, 17.0; P = 0.600 and 53.5%; RD: -2.3%; 95%CI: -16.1, 11.5; P = 0.744, respectively).

CONCLUSION

The two-week fexuprazan treatment was superior to the two-week rebamipide treatment and similar to the four-week rebamipide treatment for patients with gastritis.

Keywords: Gastritis; Erosive gastritis; Fexuprazan; Rebamipide; Matching-adjusted indirect comparison; Indirect treatment comparison

Core Tip: In a matching-adjusted indirect comparison, the effectiveness of fexuprazan, a novel potassium-competitive acid blocker, was compared with that of rebamipide, one of the most commonly used mucoprotective agents for acute and chronic gastritis in a real-world setting in South Korea. We conclude that a two-week fexuprazan treatment is superior to a two-week rebamipide treatment and similar to a four-week rebamipide treatment for patients with gastritis.