Shinozaki Satoshi, Osawa Hiroyuki, Hayashi Yoshikazu, Miura Yoshimasa, Lefor Alan Kawarai, Yamamoto Hironori
Shinozaki Medical Clinic, Utsunomiya, Tochigi 321-3223, Japan.
Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Tochigi 329-0498, Japan.
Biomed Rep. 2021 Mar;14(3):32. doi: 10.3892/br.2021.1408. Epub 2021 Feb 1.
Vonoprazan, a novel potassium-competitive acid blocker, results in greater inhibition of gastric acid secretion than proton pump inhibitors (PPI). The aim of this study was to assess the long-term outcomes of patients with PPI-resistant gastroesophageal reflux disease (GERD) treated with vonoprazan. The medical records of patients with symptomatic GERD treated with vonoprazan for 1 year were retrospectively reviewed. Changes in abdominal symptoms were assessed using the Izumo scale, a self-reported questionnaire which is useful in evaluating the symptoms of GERD, epigastric pain, postprandial distress, constipation and diarrhea, and is commonly used in routine clinical practice. A total of 30 patients were included and stratified into a non-erosive (n=22) and erosive group (n=8). At baseline, postprandial distress symptoms were significantly greater in the non-erosive group compared with the erosive group (P=0.013). Even with vonoprazan therapy, symptoms of GERD in the non-erosive group were refractory compared with the erosive group, and required additional treatment in a larger proportion of patients (45 vs. 13%). GERD symptoms in the non-erosive group significantly improved from baseline and remained better after 1 year of vonoprazan therapy, similar to the erosive group. In addition, vonoprazan improved epigastric pain and postprandial distress symptoms in the non-erosive group, and 1 year of vonoprazan therapy did not aggravate constipation or diarrhea. In conclusion, 1 year of vonoprazan therapy improves GERD symptoms in patients with PPI-resistant GERD.
沃克沙唑，一种新型钾离子竞争性酸阻滞剂，比质子泵抑制剂（PPI）能更有效地抑制胃酸分泌。本研究旨在评估接受沃克沙唑治疗的PPI难治性胃食管反流病（GERD）患者的长期疗效。对接受沃克沙唑治疗1年的有症状GERD患者的病历进行回顾性分析。使用出云量表评估腹部症状变化，这是一种自我报告问卷，有助于评估GERD症状、上腹部疼痛、餐后不适、便秘和腹泻，常用于常规临床实践。共纳入30例患者，分为非糜烂性组（n = 22）和糜烂性组（n = 8）。基线时，非糜烂性组的餐后不适症状显著高于糜烂性组（P = 0.013）。即使采用沃克沙唑治疗，非糜烂性组的GERD症状与糜烂性组相比仍难以缓解，且更多患者需要额外治疗（45%对13%）。非糜烂性组的GERD症状较基线显著改善，沃克沙唑治疗1年后仍保持较好状态，与糜烂性组相似。此外，沃克沙唑改善了非糜烂性组的上腹部疼痛和餐后不适症状，且1年的沃克沙唑治疗未加重便秘或腹泻。总之，1年的沃克沙唑治疗可改善PPI难治性GERD患者的GERD症状。
