Have You Figured Out the Wide-Spectrum Clinical Advantages of Vonoprazan for Gastric Acid Complications?

Acid suppressive therapy by proton pump inhibitors (PPIs) is the first-line therapy for gastroesophageal reflux disease (GERD).¹ However, around 33% of patients with GERD fail to respond to PPIs, necessitating further medical care.¹ This PPI-refractory GERD has turned out to be an expensive clinical issue owing to the repetitive usage of healthcare resources.¹ Further, reflux esophagitis (RE) secondary to GERD is another complication and its severity has been categorized into four grades—A, B, C, and D as per the Los Angeles (LA) classification.²

Vonoprazan is a novel potassium-competitive acid blocker discovered and developed in Japan.^1,3 This gastric acid suppressant is fast-acting and does not require acid-induced activation.^1,3 To evaluate its efficacy compared to PPIs, PPI-treated patients with persistent reflux symptoms and pathological esophageal acid exposure times (EAET) ≥4% were switched to vonoprazan in a retrospective study.¹ Vonoprazan significantly reduced median gastric acid exposure times (GAET) to 23.8% compared to 41.4% by PPIs, p=0.01.¹

Further, in a prospective study examining the effectiveness of vonoprazan in patients with PPI-resistant RE with LA grades A–D, it was observed that vonoprazan resulted in endoscopic healing of 87.5% of the patients.⁴

Conclusion

Vonoprazan provides more potent gastric acid suppression, including better EAET and GAET control than PPIs in PPI-refractory GERD.¹ The drug also significantly supports endoscopic healing in RE.⁴ 

CTA: Let us listen to the expert, Dr. Philip Abraham, and scout the clinical advantages of vonoprazan in gastric acid complications.

1. Akiyama J, Hosaka H, Kuribayashi S, et al. Efficacy of vonoprazan, a novel potassium-competitive acid blocker, in patients with proton pump inhibitor-refractory acid reflux. Digestion. 2020;101(2):174–183.
2. Azer SA, Hashmi MF, Reddivari AKR. Gastroesophageal reflux disease (GERD). In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available at: https://www.ncbi.nlm.nih.gov/books/NBK554462/. Accessed on: 20 November 2024.
3. Kawai T, Suzuki C, Honda Y, et al. Long-term safety and effectiveness of vonoprazan for prevention of gastric and duodenal ulcer recurrence in patients on nonsteroidal anti-inflammatory drugs in Japan: A 12-month post-marketing surveillance study. Expert Opin Drug Saf. 2023;22(5):425–431.
4. Hoshino S, Kawami N, Takenouchi N, et al. Efficacy of vonoprazan for proton pump inhibitor-resistant reflux esophagitis. Digestion. 2017;95(2):156–161.