Comparative efficacy and safety of fexuprazan versus esomeprazole in gastroesophageal reflux disease: a systematic review and meta-analysis.

Publication/Presentation Date

1-1-2026

Abstract

BACKGROUND: Fexuprazan is a newly emerging potassium-competitive acid blocker (P-CAB) medication. P-CAB drugs have been introduced as alternative medications for gastroesophageal reflux disease (GERD) instead of traditionally used proton-pump inhibitors (PPIs).

AIM: This study aims to compare the efficacy and safety of fexuprazan in contrast to esomeprazole.

METHODS: An electronic search was conducted on major databases, and retrieved results were subjected to two stages of filtration based upon a preset inclusion criterion. The first stage filtered articles based on their titles and abstracts, and the second stage filtered articles based on their full texts. Articles found fit to include in this study were extracted using a pre-set piloted extraction form. Extraction results were introduced into a spreadsheet. Data was divided into categorical and numerical data. Categorical data was reported as counts and frequencies, while continuous data was reported as proportions, means, and standard deviations. Common and random effect meta-analyses were conducted as found fit. Risk of bias assessment was performed using the Cochrane's risk of bias assessment (RoB 2.0) tool.

RESULTS: Five articles were included in the present review, describing 965 patients managed with fexuprazan 40 mg or esomeprazole 40 mg for a mean of 9.6 weeks. The mean age of patients was 50.2 ± 13.0 years. GERD symptom scores showed a numerically lower value in the fexuprazan group (SMD - 0.41 [95% CI: -1.10; 0.29],

CONCLUSION: No statistically significant difference in efficacy was identified between fexuprazan and esomeprazole; however, preliminary findings are consistent with non-inferiority. No statistically significant difference in the incidence of TEAEs or ADRs was observed between treatments, suggesting a comparable safety profile.

SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261286108.

Volume

13

First Page

1852781

Last Page

1852781

ISSN

2296-858X

Disciplines

Medicine and Health Sciences

PubMedID

42180768

Department(s)

Fellows and Residents

Document Type

Article

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