Efficacy and safety of tegoprazan‐ and rabeprazole‐based concomitant therapies for Helicobacter pylori infection: Real‐world evidence

Abstract Background and Aim Tegoprazan, a novel potassium‐competitive acid blocker, has been approved for Helicobacter pylori eradication in Korea. We compared the efficacy and safety of tegoprazan‐ and rabeprazole‐based concomitant therapies for H. pylori eradication in real‐world clinical practice. Methods We retrospectively analyzed data from patients with H. pylori infection treated with tegoprazan‐ or rabeprazole‐based concomitant therapies. The primary endpoint was H. pylori eradication rate. The secondary endpoint was adverse events. Results Among the 1474 included patients, 620 and 854 received tegoprazan‐ and rabeprazole‐based concomitant therapies, respectively. Intention‐to‐treat analysis showed no significant difference in the eradication rates between the tegoprazan‐ and rabeprazole‐based concomitant therapy groups (74.7% [95% confidence interval [CI], 71.1–78.0%] vs 72.7% [95% CI, 69.7–75.6%], P = 0.400). Per‐protocol analysis also demonstrated similar eradication rates for the groups (tegoprazan vs rabeprazole: 88.0% [95% CI, 85.0–90.6%] vs 85.9% [95% CI, 83.2–88.3%], P = 0.288). Although the overall adverse event rate did not differ between groups (tegoprazan vs rabeprazole, 39.2% vs 40.6%, P = 0.578), abdominal discomfort was less frequent in the tegoprazan group than in the rabeprazole group (1.3 vs 4.8%, P = 0.001). Conclusions Tegoprazan‐ and rabeprazole‐based concomitant therapies for H. pylori eradication showed comparable efficacy and overall safety. The effect of tegoprazan on dose increases or other regimens, such as bismuth‐containing quadruple therapy, should be further evaluated, because the efficacy of tegoprazan‐based concomitant therapy may be suboptimal in regions where the clarithromycin resistance rate is high.