Hoshikawa Yoshimasa, Kawami Noriyuki, Hoshino Shintaro, Tanabe Tomohide, Umezawa Mariko, Kaise Mitsuru, Iwakiri Katsuhiko
Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
Esophagus. 2019 Apr;16(2):201-206. doi: 10.1007/s10388-018-00654-9. Epub 2019 Jan 1.
To evaluate the efficacy of on-demand therapy using 20-mg vonoprazan for non-erosive reflux disease.
On-demand therapy by taking one 20-mg tablet of vonoprazan only when reflux symptoms occurred was performed for 8 weeks by 30 patients (11 men, mean age: 67.8) with non-erosive reflux disease who responded well to maintenance therapy using proton pump inhibitor and answered "very satisfied" or "satisfied" to an overall satisfaction survey (5-grade scale). The degree of overall satisfaction with the treatment, score of symptoms, and fasting gastrin levels before breakfast was examined before and after on-demand therapy. The number of vonoprazan tablets taken and the frequency (regular, temporary, rare) of its administration were also investigated.
All patients completed 8-week on-demand therapy with 20-mg vonoprazan. Comparisons of patient satisfaction levels before and after therapy revealed no significant differences in the number of patients who were very satisfied and satisfied with the therapy. Furthermore, there were no significant differences in score of symptoms or gastrin levels before and after therapy. During 8-week on-demand therapy, patients took 11 tablets (median) (7.0-18.0 tablets: 25-75 percentiles), and 30.0% of patients (n = 9) took vonoprazan on a regular basis (at least 2 tablets a week).
On-demand therapy with 20-mg vonoprazan exerted equivalent effects to continuous PPI maintenance therapy for patients with non-erosive reflux disease.
评估按需服用20毫克沃克(富马酸伏诺拉生)治疗非糜烂性反流病的疗效。
对30例(11名男性,平均年龄67.8岁)非糜烂性反流病患者进行按需治疗,这些患者对质子泵抑制剂维持治疗反应良好,且在总体满意度调查(5级量表)中回答“非常满意”或“满意”。仅在出现反流症状时服用一片20毫克的沃克进行按需治疗,为期8周。在按需治疗前后,检查对治疗的总体满意度、症状评分以及早餐前空腹胃泌素水平。还调查了服用沃克的片数及其给药频率(规律、临时、偶尔)。
所有患者均完成了为期8周的20毫克沃克按需治疗。治疗前后患者满意度水平比较显示,对治疗非常满意和满意的患者数量无显著差异。此外,治疗前后症状评分或胃泌素水平也无显著差异。在8周的按需治疗期间,患者服用了11片(中位数)(7.0 - 18.0片:第25 - 75百分位数),30.0%的患者(n = 9)规律服用沃克(每周至少2片)。
对于非糜烂性反流病患者,20毫克沃克按需治疗与持续质子泵抑制剂维持治疗效果相当。