Jung Byung Wook, Park Chan Hyuk, Eun Chang Soo
Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri 11923, Republic of Korea.
Department of Medicine, Graduate School, Yonsei University College of Medicine, Seoul 03722, Republic of Korea.
J Pers Med. 2025 Jan 6;15(1):19. doi: 10.3390/jpm15010019.
Maintenance therapy is crucial in managing and preventing symptom relapse in gastroesophageal reflux disease (GERD), with continuous and on-demand therapy being the common approaches. However, maintenance therapy using potassium-competitive acid blockers (P-CABs), such as fexuprazan, remains incompletely evaluated. This single-center, single-arm, prospective cohort study enrolled individuals with weekly heartburn or acid regurgitation and confirmed erosive esophagitis. The participants received 40 mg fexuprazan daily for 4 weeks as initial therapy, followed by 4 weeks of maintenance therapy. Patients chose either continuous or on-demand therapy for maintenance, according to their preference. The primary endpoint was the proportion of patients selecting on-demand therapy. The symptom scores were assessed using the GERD questionnaire (GERD-Q) and patient assessment of upper-gastrointestinal-disorders symptoms questionnaire (PAGI-SYM). The 31 included participants showed a significant reduction in symptom scores after initial treatment (baseline vs. 4-week: GERD-Q, 9.0 vs. 6.5, < 0.001; PAGI-SYM, 29.0 vs. 10.8, < 0.001). Twenty-one (67.7%) patients chose on-demand therapy after initial treatment. The symptom scores did not differ significantly before and after maintenance therapy (4-week vs. 8-week: GERD-Q, 6.5 vs. 6.0, = 0.225; PAGI-SYM, 10.8 vs. 9.0, = 0.354). Although this relation was not significant, patients experiencing larger decreases in symptom scores tended to prefer on-demand therapy. After maintenance therapy, the symptom scores did not differ between continuous and on-demand therapy (GERD-Q, 5.3 vs. 6.3, = 0.342; PAGI-SYM, 9.4 vs. 8.8, = 0.611). Fexuprazan was effective as an initial and maintenance therapy in patients with GERD who showed typical symptoms. Approximately 68% of the patients preferred on-demand therapy as a maintenance treatment. Based on the patient's preference for maintenance therapy, symptom control did not differ between continuous and on-demand therapy.
维持治疗对于控制和预防胃食管反流病（GERD）症状复发至关重要，持续治疗和按需治疗是常用方法。然而，使用钾离子竞争性酸阻滞剂（P-CABs）如伏诺拉生进行维持治疗的效果仍未得到充分评估。这项单中心、单臂、前瞻性队列研究纳入了每周有烧心或反酸症状且确诊为糜烂性食管炎的患者。参与者接受每日40mg伏诺拉生治疗4周作为初始治疗，随后进行4周的维持治疗。患者根据自身偏好选择持续或按需维持治疗。主要终点是选择按需治疗的患者比例。使用GERD问卷（GERD-Q）和上消化道疾病症状患者评估问卷（PAGI-SYM）评估症状评分。纳入的31名参与者在初始治疗后症状评分显著降低（基线 vs. 4周：GERD-Q，9.0 vs. 6.5，<0.001；PAGI-SYM，29.0 vs. 10.8，<0.001）。21名（67.7%）患者在初始治疗后选择按需治疗。维持治疗前后症状评分无显著差异（4周 vs. 8周：GERD-Q，6.5 vs. 6.0，=0.225；PAGI-SYM，10.8 vs. 9.0，=0.3５4）。虽然这种关系不显著，但症状评分下降幅度较大的患者倾向于选择按需治疗。维持治疗后，持续治疗和按需治疗的症状评分无差异（GERD-Q，5.3 vs. 6.3，=0.342；PAGI-SYM，9.4 vs. 8.8，=0.611）。伏诺拉生对有典型症状的GERD患者作为初始和维持治疗有效。约68%的患者倾向于选择按需治疗作为维持治疗。基于患者对维持治疗的偏好，持续治疗和按需治疗在症状控制方面无差异。
