Department of Gastroenterology, Toyama City Hospital, Toyama, Japan,
Department of Gastroenterology, Toyama City Hospital, Toyama, Japan.
Digestion. 2020;101(4):411-421. doi: 10.1159/000500399. Epub 2019 May 24.
We aimed to evaluate the efficacy of vonoprazan (VPZ) as maintenance therapy for healed reflux esophagitis (RE).
We enrolled 74 patients diagnosed with RE with frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) total score ≥8 after at least 8 weeks of treatment with standard proton pump inhibitors (PPIs). These patients were switched to VPZ 20 mg for 4 weeks. We also enrolled 71 patients with no endoscopic evidence of erosive esophagitis who received maintenance therapy with VPZ 10 mg for 48 weeks. The primary end point was the proportion of patients who maintained healed RE refractory to PPIs after 48 weeks of maintenance therapy with on demand 10 mg VPZ. Secondary assessment included the proportion of patients with symptomatic nonrelapse at 48 weeks.
Fifty patients successfully completed 48-week maintenance therapy. Maintenance therapy with VPZ 10 mg prevented the relapse of esophageal mucosal breaks in 43 (86.0%) of 50 patients at 48 weeks. During the 48-week maintenance therapy, symptomatic nonrelapse rate for acid reflux-related symptom score of FSSG and acid reflux score of Gastrointestinal Symptom Rating Scale at 48 weeks were 70.0 and 72.0%, respectively. No serious adverse events were reported during the study.
VPZ 10 mg is clinically effective for maintenance of healed RE for 48 weeks.
我们旨在评估沃诺拉赞(VPZ)作为愈合性反流性食管炎(RE)维持治疗的疗效。
我们纳入了 74 名经诊断患有 RE 的患者,这些患者在接受标准质子泵抑制剂(PPIs)治疗至少 8 周后,症状频率量表评估胃食管反流病(FSSG)总评分≥8。这些患者转换为 VPZ 20mg 治疗 4 周。我们还纳入了 71 名无内镜可见的糜烂性食管炎患者,他们接受 VPZ 10mg 维持治疗 48 周。主要终点是在按需使用 10mg VPZ 进行 48 周维持治疗后,维持 PPI 难治性愈合性 RE 的患者比例。次要评估包括 48 周时有症状且无复发的患者比例。
50 名患者成功完成了 48 周的维持治疗。VPZ 10mg 维持治疗可预防 50 名患者中的 43 名(86.0%)在 48 周时食管黏膜破裂的复发。在 48 周的维持治疗期间,FSSG 的酸反流相关症状评分和胃肠道症状评分量表的酸反流评分在 48 周时无症状复发率分别为 70.0%和 72.0%。研究期间未报告严重不良事件。
VPZ 10mg 对 48 周愈合性 RE 的维持治疗是有效的。