The effects of
vonoprazan, a new
potassium-competitive
acid blocker, on
gastroesophageal reflux disease (
GERD) symptom are not fully elucidated. The aim of this study is to determine the effect of
vonoprazan on
GERD and associated gastrointestinal symptoms. We retrospectively reviewed 88 Helicobacter pylori negative patients with
GERD treated with
vonoprazan 10 mg daily. Symptoms were evaluated using the Izumo scale, which reflects quality of life related to various abdominal symptoms. The rates of improvement and resolution of
GERD symptoms were 86% (76/88) and 57% (50/88), respectively. Improvement and resolution in patients with erosive
esophagitis was higher than in those with
non-erosive reflux disease (91% vs 83%, p = 0.260 and 71% vs 47%, p = 0.025, respectively). We attempted to identify factors which predict the effects of
vonoprazan. Multivariate analysis identified advanced age (≥60-year-old) (odds ratio [OR] 7.281, 95% confidence interval [CI] 2.056-25.776, p = 0.002),
obesity (BMI ≥ 24) (OR 3.342, 95%CI 1.124-9.940, p = 0.030) and erosive
esophagitis (OR 4.368, 95%CI 1.281-14.895, p = 0.018) as positive predictors of resolution of
GERD symptoms. Alcohol use (OR 0.131, 95%CI 0.027-0.632, p = 0.011) and history of H. pylori eradication (OR 0.171, 95%CI 0.041-0.718, p = 0.015) were identified as negative predictors.
Vonoprazan also improved epigastric
pain (73%), postprandial distress (60%),
constipation (58%) and
diarrhea (52%) in patients with
GERD. In conclusion,
vonoprazan 10 mg daily is effective in improving
GERD symptoms. Advanced age,
obesity, erosive
esophagitis, alcohol use and history of H. pylori eradication influence the resolution of
GERD symptoms. Treatment with
vonoprazan favorably affects gastrointestinal symptoms in patients with
GERD.