Vonoprazan May Be More Effective Than PPIs for Erosive Gastroesophageal Reflux Disease

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Study examines whether every-second-day administration of vonoprazan reduces symptoms more effectively than proton pump inhibitors in patients with erosive GERD.

Vonoprazan administered every second day may be a more effective maintenance treatment than proton pump inhibitors (PPIs) in patients with erosive gastroesophageal reflux disease (GERD), according to research presented at the Liver Meeting Digital Experience™, hosted by the American Association for the Study of Liver Diseases.

The prospective, multicenter, open-label study included 122 patients with erosive GERD enrolled between December 2017 and May 2019. Investigators randomly assigned the participants to the PCPP group, which was administered vonoprazan, a potassium competitive acid blocker, 10 mg/d every day for the first 4 weeks and then lansoprazole, 15 mg/d for the next 4 weeks, both administered every second day, as well as to the PPPC group, which received treatment in a reverse fashion. The investigators compared GERD symptoms, including heartburn and acid reflux between vonoprazan and lansoprazole using symptom diaries, the frequency scale for symptoms of GERD (FSSG), and the gastrointestinal symptom rating scale (GSRS).

The asymptomatic proportions in vonoprazan administration and lansoprazole administration were 93.6% (105/112) and 82.1% (92/112), respectively. The difference was significant with analysis using the McNemar test (P =.003). In the first 4 weeks, 93.3% and 85.7% patients were asymptomatic after treatment for at least 6 consecutive days a week in the PCPP and PPPC groups, respectively (P =.228). In the second 4 weeks, 94.4% and 76.7% of patients, respectively, were asymptomatic (P =.009).

In addition, 96.7% and 80% of patients were asymptomatic with less than once-weekly administration in the PCPP and PPPC groups, respectively, during the first 4 weeks (P =.007). GERD symptoms were found to be decreased significantly with vonoprazan administered every second day according to scores on the FSSG and GERD.

“Vonoprazan every second day administration may reduce patient symptoms more effectively than PPIs in erosive GERD maintenance,” stated the researchers. “Furthermore, vonoprazan could be effective maintenance therapies because of their inhibitory effects on gastric acid secretion even when administered every second day and could be selected on-demand. However, further research on long-term administration effects would be necessary.”

Disclosures: One of the study authors reported an affiliation with a pharmaceutical company. Please see the original reference for a full list of disclosures.


Matsuda S, Kato M, Sakakibara Y, et al. A study for every second day administration of vonoprazan in maintenance treatment of erosive GERD (ESD Von GERD): a multicenter randomized crossover study. ePoster presented at: the Liver Meeting Digital Experience; November 13-16, 2020. P2818 (S1351).