Short-Term Symptomatic Relief in Gastroesophageal Reflux Disease: A Comparative Study of Esomeprazole and Vonoprazan

Kouichi Sakurai, Hiroko Suda, Satomi Fujie, Takayuki Takeichi, Ayako Okuda, Tetsuya Murao, Kiwamu Hasuda, Masahiro Hirano, Kiyoharu Ito, Katsuie Tsuruta, Masahiro Hattori, Kouichi Sakurai, Hiroko Suda, Satomi Fujie, Takayuki Takeichi, Ayako Okuda, Tetsuya Murao, Kiwamu Hasuda, Masahiro Hirano, Kiyoharu Ito, Katsuie Tsuruta, Masahiro Hattori

Abstract

Background and aim: Proton pump inhibitors and vonoprazan (a potassium-competitive acid blocker) are recommended as first-line treatments for gastroesophageal reflux disease (GERD). However, few reports have investigated the onset of action of these agents for GERD symptom relief. The present study compared the symptom relief of esomeprazole with that of vonoprazan via monitoring self-reported GERD symptoms after treatment initiation.

Methods: This was a prospective, multicenter, randomized, open-label, parallel group, comparative clinical study between esomeprazole (20 mg/day) and vonoprazan (20 mg/day) administered for 4 weeks to patients with GERD symptoms. Patients who had scores ≥ 8 on the Gastroesophageal Reflux Disease Questionnaire (GerdQ) were defined as having GERD and enrolled in this study. Sixty patients were randomly assigned to either the esomeprazole group (n = 30) or the vonoprazan group (n = 30). Treatment response rates in each drug group were evaluated according to the GerdQ. The Frequency Scale for the Symptoms of GERD (FSSG) scores from the 1st day after treatment initiation and the Global Overall Symptom (GOS) scale scores during treatment were also evaluated.

Results: At 4 weeks, the treatment response rates for symptom relief according to the GerdQ were 88.0% in the esomeprazole group and 81.8% in the vonoprazan group. The GOS scales, which reflect the impact of GERD symptoms, were similar for both groups. The FSSG scores decreased from the 1st to the 14th day in both groups.

Conclusions: There were no substantial differences in the symptom relief between the two groups at any time point in this short-term study.

Keywords: Esomeprazole; Gastroesophageal reflux disease; Symptom relief; Vonoprazan.

Conflict of interest statement

The authors declare that they have no conflicts of interest related to this manuscript.

Figures

Fig. 1
Fig. 1
Overview of the study design. GerdQ Gastroesophageal Reflux Disease Questionnaire; FSSG Frequency Scale for the Symptoms of GERD; GOS Global Overall Symptoms; Upper GI upper gastrointestinal endoscopy
Fig. 2
Fig. 2
Percentage of patients with complete resolution and sufficient relief as evaluated by the GerdQ after treatment with 20 mg of esomeprazole once daily (n = 25) or 20 mg of vonoprazan once daily (n = 22). Sufficient relief was defined by a score ≤ 1 for each positive predictor question (1, 2, 5, and 6) on the GerdQ. Complete resolution was defined by a score of 0 for all questions. Error bars indicate 95% confidence intervals
Fig. 3
Fig. 3
a Changes in FSSG scores prior to and after treatment with 20 mg of esomeprazole once daily (n = 25) or 20 mg of vonoprazan once daily (n = 22). Each score is presented as the mean value and standard error. Reflux and dysmotility scores were defined according to Kusano et al. [11]. b Rate of decreased FSSG scores after treatment with 20 mg of esomeprazole once daily (n = 25) or 20 mg of vonoprazan once daily (n = 22). Reflux and dysmotility scores were defined according to Kusano et al. [11]
Fig. 4
Fig. 4
Percentage of patients with complete resolution and sufficient relief as evaluated using the GOS scale after treatment with 20 mg of esomeprazole once daily (n = 25) or 20 mg of vonoprazan once daily (n = 22). Sufficient relief was defined by a score ≤ 2 for each heartburn or regurgitation question on the GOS scale. Complete resolution was defined by a score of 1 on the respective GOS scale question

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