Key result
Gastric acid suppressants reduce VEGFR-TKI bioavailability by ~20%, potentially worsening survival outcomes.
Why the study?
To evaluate the prevalence of gastric acid suppressants in patients receiving VEGFR-TKIs and explore potential drug-drug interactions.
Does the addition of gastric acid suppressants reduce the efficacy of VEGFR-TKIs in patients receiving VEGFR-TKIs?
Meta-Analysis
Does the addition of gastric acid suppressants reduce the efficacy of VEGFR-TKIs in patients receiving VEGFR-TKIs?
Gastric acid suppressants may reduce the efficacy of VEGFR-TKIs by decreasing their bioavailability, potentially worsening patient survival outcomes.
Answers are grounded in this paper and cite their sources.
Clinicians should consider alternatives to gastric acid suppressants with VEGFR-TKIs; leaves open survival impact pending dedicated outcome trials.
BACKGROUND: This meta-analysis evaluated the prevalence of gastric acid suppressants (GASs) in patients receiving vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs) and explored drug-drug interactions (DDIs). METHODS: PubMed, Embase, and Cochrane Library were searched upto 20 October 2024. Studies comparing VEGFR-TKIs monotherapy versus VEGFR-TKIs with GASs, reporting pharmacodynamic (PD), pharmacokinetic (PK), or adverse events (AEs), were analyzed using random-effects models. Subgroups included cancer types and VEGFR-TKI types. RESULTS: GMR 0.80, 90% CI 0.70-0.91). AE incidence (except vomiting) did not differ between groups. CONCLUSION: GASs may reduce the efficacy of most types of VEGFR-TKIs by decreasing their bioavailability, thereby having a detrimental effect on patient survival outcomes. It is recommended to give priority to H2 receptor antagonists (H2RAs) and monitor blood drug concentrations to optimize efficacy. PROTOCOL REGISTRATION: www.crd.york.ac.uk/prospero identifier CRD42024597729.
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Luo et al. (2025) conducted a meta-analysis in Patients receiving vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs). Gastric acid suppressants (GASs) vs. VEGFR-TKIs monotherapy was evaluated on Pharmacodynamic (PD), pharmacokinetic (PK), or adverse events (AEs) (GMR 0.80, 95% CI 0.70-0.91). Concomitant use of gastric acid suppressants with VEGFR-TKIs reduces their bioavailability (GMR 0.80; 90% CI 0.70-0.91), potentially having a detrimental effect on patient survival outcomes.
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