Efficacy and Tolerability of Tegoprazan Compared to Proton Pump Inhibitors in the Treatment of Erosive Esophagitis: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

Aim Tegoprazan, a potassium‐competitive acid blocker, is an acid‐suppressing medication under review as a potential alternative treatment in cases of erosive esophagitis. This systematic review and meta‐analysis assesses the efficacy and tolerability of tegoprazan compared to proton pump inhibitors, the current standard of care. Methods Pubmed, Cochrane Library, Web of Science, Scopus, Embase, and Medline Ovid were systematically searched for articles up to November 25, 2025. Inclusion criteria selected RCTs that included patients with erosive esophagitis and studies of safety and efficacy, while exclusion criteria were defined by nonhuman studies, healthy patient populations, Helicobacter pylori ‐positive populations, and non‐RCT publication types. This review was registered with PROSPERO (CRD42024602209). Results Out of 724 screened studies, 5 RCTs were selected for this review, with a total of 1386 patients. Tegoprazan efficacy outcomes were consistent with non‐inferiority when compared to PPIs in the healing of erosive esophagitis (risk ratio: 1.03, 95% confidence interval: 1.00–1.07), as confirmed endoscopically. Comparable tolerability was also demonstrated (rate ratio: 0.97, 95% confidence interval: 0.68–1.37), with a similar distribution of treatment‐emergent adverse events across treatment groups. Conclusions Tegoprazan was non‐inferior to PPIs in both efficacy and tolerability, in accordance with the definition of non‐inferiority set by the RCTs. This supports its potential use as an alternative treatment in patients with erosive esophagitis.