title: Efficacy of Vonoprazan for Proton Pump Inhibitor-Resistant Reflux Esophagitis.
abstract: BACKGROUND
  Vonoprazan (VPZ) is a novel potassium-competitive acid blocker that may be clinically beneficial for proton pump inhibitor (PPI)-resistant reflux esophagitis (RE). The aim of this study was to investigate the efficacies of VPZ therapy at 20 mg for 4 weeks in patients with PPI-resistant RE and VPZ maintenance therapy at 10 mg for 8 weeks in patients who have been successfully treated.
  
  
  METHODS
  Subjects comprised 24 patients with PPI-resistant RE (Los Angeles classification grade A/B/C/D: 3/7/11/3). After confirming PPI-resistant RE by endoscopy, 20 mg VPZ was administered. Endoscopy was performed 4 weeks after the initiation of VPZ. Symptoms were evaluated using the frequency scale for the symptoms of gastroesophageal reflux disease (FSSG). Maintenance therapy with 10 mg VPZ was performed and endoscopy was conducted after 8 weeks.
  
  
  RESULTS
  In 21 (87.5%) out of 24 patients, esophageal mucosal breaks were successfully treated by 20 mg VPZ. The median FSSG score was significantly lower on days 1-7, 14, and 28 after the initiation of VPZ than before its administration. Maintenance therapy with 10 mg VPZ prevented the relapse of esophageal mucosal breaks in 16 (76.2%) out of 21 patients.
  
  
  CONCLUSIONS
  VPZ was effective for most patients with PPI-resistant RE.
authors.affiliation: Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine, Tokyo, Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Hoshino
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Kawami
authors.forename: Nana
authors.initials: N
authors.lastname: Takenouchi
authors.forename: Mariko
authors.initials: M
authors.lastname: Umezawa
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Hanada
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Hoshikawa
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Kawagoe
authors.forename: Hirohito
authors.initials: H
authors.lastname: Sano
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Hoshihara
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nomura
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Iwakiri
mesh_terms: D000368:Aged; D004351:Drug Resistance; D004724:Endoscopy; D000071041:Esophageal Mucosa / Q000187:drug effects; D004942:Esophagitis, Peptic / Q000000981:diagnostic imaging / Q000178:diet therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D060046:Maintenance Chemotherapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use*; D011758:Pyrroles / Q000008:administration & dosage / Q000627:therapeutic use*; D012720:Severity of Illness Index; D013449:Sulfonamides / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: C552956:1-(5-(2-fluorophenyl)-1-(pyridin-3-ylsulfonyl)-1H-pyrrol-3-yl)-N-methylmethanamine; D054328:Proton Pump Inhibitors; D011758:Pyrroles; D013449:Sulfonamides