Objective  To evaluate the efficacy, safety and economy of vonoprazan in the treatment of post-endoscopic submucosal dissection (ESD) ulcer by rapid health technology assessment method, and to provide reference for clinical treatment decision.

Methods  PubMed, Cochrane Library, Embase, ScienceDirect, CNKI, WanFang Data databases and the official website of health technology assessment (HTA) agency were electronically searched to collect HTA reports, systematic reviews/Meta-analysis and pharmacoeconomic studies of vonoprazan in the treatment of post-ESD ulcer from inception to July 31, 2024. Two researchers independently screened literature, extracted data, and comprehensively analyzed the results of the included literature on the basis of literature quality evaluation.

Results  A total of 8 studies were included, all were systematic reviews/Meta-analysis. In terms of effectiveness, compared with proton pump inhibitors (PPI), vonoprazan significantly increased the overall ulcer healing rate after ESD and more rapid reduction of ulcer area (P<0.05). The results of subgroup analysis showed that there was no significant difference in ulcer healing rate between vonoprazan and PPI treatment at 4 or 8 weeks after ESD (P>0.05). Vonoprazan significantly increased the rate of postoperative ulcer reduction in H. pylori positive patients compared with PPI (P<0.05). In terms of safety, compared with PPI, vonoprazan reduced the incidence of overall adverse events rate (P<0.05). The difference in the incidence of delayed bleeding and ulcer perforation between vonoprazan and PPIs showed no statistically significant difference. (P>0.05).

Conclusion  Vonoprazan demonstrated favorable efficacy and safety in the treatment of ESD ulcers, and further economic studies are warranted.

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