A study for every second day administration of vonoprazan for maintenance treatment of erosive GERD (ESD von GERD): a multicenter randomized cross-over study

Soichiro Matsuda, Mototsugu Kato, Yuko Sakakibara, Hiroshige Hamada, Yoshihiro Sasaki, Hideki Mori, Yuichiro Hirai, Shuji Inoue, Tatsuya Toyokawa, Takashi Kagaya, Toshio Kuwai, Naoki Esaka, Haruhiro Yamashita, Noriko Watanabe, Mio Matsumoto, Hiroyuki Fujii, Mamiko Demura, Kimitoshi Kubo, Katsuhiro Mabe, Naohiko Harada

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Background: Vonoprazan is a potassium competitive acid blocker used to treat erosive gastroesophageal reflux disease (GERD) with stronger, more stable acid-suppressing effects than proton pump inhibitors (PPIs). This study clarified the usefulness and superiority of vonoprazan administered every second day over PPIs in the maintenance therapy of erosive GERD. Methods: This is a prospective, multicenter, open-label, two-period randomized cross-over study. Patients were randomized to either the vonoprazan-lansoprazole (VP-LZ) group, who were given vonoprazan 10 mg for the first 4 weeks and then lansoprazole 15 mg for the next 4 weeks both administered once every second day, or the lansoprazole-vonoprazan (LZ-VP) group, who were treated in reverse. GERD symptoms were compared using symptom diaries, the frequency scale for symptoms of GERD (FSSG), and the gastrointestinal symptom rating scale (GSRS). Results: We enrolled 122 patients between December 2017 and May 2019. Symptoms were well controlled in vonoprazan administration and lansoprazole administration were 93.6% and 82.1%, respectively, with a significant difference on McNemar’s test (P = 0.003). During the second 4 weeks, 94.4% and 76.7% of patients in the VP-LZ and LZ-VP groups, respectively, were well controlled following for ≥ 6 consecutive days a week (P = 0.009). During the first 4 weeks, 96.7% and 80.0% of patients were well controlled with < 1 weekly in the VP-LZ and LZ-VP groups, respectively, during the first 4 weeks (P = 0.007). GERD symptoms, assessed via FSSG and GSRS, significantly decreased with vonoprazan administration once every second day. Conclusions: Vonoprazan administered once every second day could be an effective alternative to PPIs in the maintenance treatment of erosive GERD (UMIN000030393).

Original languageEnglish
Pages (from-to)133-143
Number of pages11
JournalJournal of gastroenterology
Volume57
Issue number3
DOIs
Publication statusPublished - 2022 Mar
Externally publishedYes

Keywords

  • Acid-related diseases
  • Erosive oesophagitis
  • Gastroesophageal reflux disease
  • Proton pump inhibition

ASJC Scopus subject areas

  • Gastroenterology

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