GERD: Gastroesophageal reflux disease; PCAB: Potassium competitive acid blockers; PPI: Proton pump inhibitor, Vonoprazan
Despite PPIs being the most effective treatment for GERD, up to 30% of GERD patients experience refractory GERD.
Several factors contribute to refractory GERD that vary in incidence, clinical importance, and symptom severity and frequency.1
PPI timing: Only 46% of patients dosed PPIs at appropriate times.2
PPI compliance: Only ~54% of patients filled their monthly PPI prescription >80% of the time.2
Acid pocket: PPI use can reduce the size of acid pocket and increase gastric pH.2
Cytochrome P450 2C19 polymorphism: PPI response varies by genotype; extensive metabolizers are more likely to have refractory symptoms on standard-dose.2
With PCABs offering potent acid suppression from the first dose,
they may soon replace PPIs as the preferred initial therapy.3
A single dose of VONOprazan can raise intragastric pH to nearly
7 within 4 hours.4
As shown in the figure, VONOprazan’s ability to maintain a 24-hour intragastric pH above 4 ensures rapid and sustained relief, making it suitable for treating breakthrough GERD symptoms and for on-demand therapy.
GERD: Gastroesophageal reflux disease; PCAB: Potassium competitive acid blockers; PPI: Proton pump inhibitor. pump inhibitor; RH: Reflux hypersensitivity; RSA: Reflux symptom association.
1. Mermelstein J, Chait Mermelstein A, Chait MM. Proton pump inhibitor-refractory gastroesophageal reflux disease: Challenges and solutions. Clin Exp Gastroenterol. 2018;11:119–134. 2. Naik RD, Meyers MH, Vaezi MF. Treatment of refractory gastroesophageal reflux disease. Gastroenterol Hepatol (N Y). 2020;16(4):196–205. 3. Davis TA, Gyawali CP. Refractory gastroesophageal reflux disease: Diagnosis and management. J Neurogastroenterol Motil. 2024;30(1):17–28. 4. Oshima T, Miwa H. Potent potassium-competitive acid blockers: A new era for the treatment of acid-related diseases. J Neurogastroenterol Motil. 2018;24(3):334–344.
LMRC Code: GGI-CO-A1-AQS-300041558-APPEMC-H24-1494 DOI of 25/08/2024 & DOE of 30/11/2024
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