Objective Clinically, patients with
proton pomp inhibitor (PPI)-resistant
gastroesophageal reflux disease (
GERD) are very challenging to treat. The aim of this study was to determine the rates of symptom relief and adverse events among PPI-resistant
GERD patients that changed their
therapy from a PPI to
vonoprazan. Methods Patients with severe
gastroesophageal reflux symptoms (total
GERD-Q score ≥8) without endoscopic findings of mucosal breaks who changed their medication from a PPI to
vonoprazan during a 12-week period from 2015 to 2016 at 2 hospitals were selected. The primary outcome was the self-reported relief of
gastroesophageal reflux symptoms. The odds ratio (OR) for the improvement of symptoms was calculated based on an exact binomial distribution using a matched-pair analysis. The secondary outcome was the
GERD-Q score and adverse events. Results Twenty-six patients (6 men) with a mean age of 67.5 years were analyzed. After the
therapy was changed from a PPI to
vonoprazan, 18 patients (69.2%) reported an improvement, 6 (23.1%) reported no change, and 2 (7.7%) reported an exacerbation of symptoms. A change in
therapy was significantly associated with improved self-reported symptoms (OR 9.0, p<0.001). The mean total
GERD-Q score during
vonoprazan treatment was significantly lower than that during PPI
therapy (11.96 vs. 8.92). There were no significant differences in the incidence of adverse events between the
therapies. Conclusion Changing the medication from a PPI to
vonoprazan was significantly associated with an improvement in
gastroesophageal reflux symptoms.
Vonoprazan is one of the most promising treatment options for patients with PPI-resistant
GERD.