Publication Name	World Journal of Gastroenterology
Manuscript ID	121372
DOI	10.3748/wjg.121372
Country	South Korea

Category	Gastroenterology & Hepatology
Manuscript Type	Meta-Analysis
Article Title	Comparative efficacy and pharmacological heterogeneity of individual potassium-competitive acid blockers: A systematic review and network meta-analysis
Manuscript Source	Unsolicited Manuscript
All Author List	Eun Jeong Gong, Chang Seok Bang, Jae Jun Lee and Gwang Ho Baik
Funding Agency and Grant Number	Funding Agency Grant Number the Bio & Medical Technology Development Program of the National Research Foundation (NRF) funded by the Korean government (MSIT) No. RS-2023-00223501
Corresponding Author	Chang Seok Bang, MD, PhD, Department of Internal Medicine, Hallym University College of Medicine, Sakju-ro 77, Chuncheon 24253, Gangwon-do, South Korea. cloudslove@naver.com
Key Words	Potassium-competitive acid blocker; Vonoprazan; Tegoprazan; Acid dissociation constant; Helicobacter pylori; Erosive esophagitis
Core Tip	Potassium-competitive acid blockers (P-CABs) suppress acid faster and more consistently than proton pump inhibitors. Over 30 meta-analyses pooled all P-CABs as a single class. Guidelines treat individual P-CABs as interchangeable. Individual P-CABs differ substantially in clinical outcomes, suggesting that efficacy may not be uniform across the class. Acid dissociation constant (pKa) values showed a positive correlation with clinical efficacy, with high-pKa P-CABs (vonoprazan, keverprazan) achieving 82%-84% eradication in clarithromycin-resistant Helicobacter pylori vs 47.8% for low-pKa tegoprazan. However, fexuprazan (pKa of 9.04) did not follow this pattern, demonstrating that pKa alone is insufficient to predict outcomes. The pKa may be one contributing factor but is not sufficient alone. Multiple pharmacological properties likely contribute to antisecretory effectiveness and clinical outcomes. These findings generate the hypothesis that pKa may inform P-CAB selection, particularly for clarithromycin-resistant infection and severe esophagitis, pending prospective validation.
Citation	Gong EJ, Bang CS, Lee JJ, Baik GH. Comparative efficacy and pharmacological heterogeneity of individual potassium-competitive acid blockers: A systematic review and network meta-analysis. World J Gastroenterol 2026; In press DOI: https://doi.org/10.3748/wjg.121372
PDF	121372-in-press.pdf

Received	2026-03-24 01:19
Peer-Review Started	2026-03-24 01:24
First Decision by Editorial Office Director	2026-04-15 08:23
Return for Revision	2026-04-15 08:23
Revised	2026-04-17 04:51
Publication Fee Transferred	2026-04-23 10:08
Second Decision by Editor	2026-06-05 03:10
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-06-05 08:13
Articles in Press	2026-06-05 08:13
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1007-9327 (print) and 2219-2840 (online)
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Copyright	©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
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