Long‑term vonoprazan therapy is effective for controlling symptomatic proton pump inhibitor‑resistant gastroesophageal reflux disease

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Abstract
Vonoprazan, a novel potassium‑competitive acid blocker, results in greater inhibition of gastric acid secretion than proton pump inhibitors (PPI). The aim of this study was to assess the long‑term outcomes of patients with PPI‑resistant gastroesophageal reflux disease (GERD) treated with vonoprazan. The medical records of patients with symptomatic GERD treated with vonoprazan for 1 year were retrospectively reviewed. Changes in abdominal symptoms were assessed using the Izumo scale, a self‑reported questionnaire which is useful in evaluating the symptoms of GERD, epigastric pain, postprandial distress, constipation and diarrhea, and is commonly used in routine clinical practice. A total of 30 patients were included and stratified into a non‑erosive (n=22) and erosive group (n=8). At baseline, postprandial distress symptoms were significantly greater in the non‑erosive group compared with the erosive group (P=0.013). Even with vonoprazan therapy, symptoms of GERD in the non‑erosive group were refractory compared with the erosive group, and required additional treatment in a larger proportion of patients (45 vs. 13%). GERD symptoms in the non‑erosive group significantly improved from baseline and remained better after 1 year of vonoprazan therapy, similar to the erosive group. In addition, vonoprazan improved epigastric pain and postprandial distress symptoms in the non‑erosive group, and 1 year of vonoprazan therapy did not aggravate constipation or diarrhea. In conclusion, 1 year of vonoprazan therapy improves GERD symptoms in patients with PPI‑resistant GERD.

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