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On-demand vonoprazan as good as PPI maintenance for nonerosive reflux

10 May 2019

Use of vonoprazan as an on-demand therapy for nonerosive reflux disease (NERD) appears to be equally effective as a proton pump inhibitor (PPI) maintenance treatment, a study has found.

For 8 weeks, a total of 30 NERD patients (mean age, 67.8 years; 36.37 percent male) took vonoprazan 20 mg only when reflux symptoms occurred. All of them had responded well to maintenance therapy using PPI and answered “very satisfied” or “satisfied” to an overall satisfaction survey (5-grade scale).

Researchers evaluated the degree of overall satisfaction with the treatment, score of symptoms and fasting gastrin levels before breakfast prior to and after on-demand therapy. They also determined the number of vonoprazan tablets taken and the frequency (regular, temporary or rare) of its administration.

All patients completed the 8-week on-demand therapy with 20-mg vonoprazan. Patient satisfaction levels revealed no significant differences in the number of patients who were satisfied and who were very satisfied with the therapy.

Moreover, symptom scores or gastrin levels before on-demand therapy were similar to those achieved at therapy conclusion.

During the 8-week on-demand therapy course, patients took a median of 11 (7.0–18.0: 25–75 percentiles) vonoprazan tablets. Nine patients (30.0 percent) took vonoprazan on a regular basis (2 tablets a week).

The present data indicate that vonoprazan on-demand therapy for NERD is as effective as maintenance therapy with PPI as reflected by patient satisfaction, according to researchers. Patients prefer the on-demand approach, as it can control reflux symptoms with a reduced administration frequency, as well as mitigates the disadvantages of medications by reducing the gastrin level.

Thus, on-demand therapy with 20-mg vonoprazan represents an attractive alternative to PPI maintenance therapy in the management of NERD, especially because it is safe and cost effective, researchers said.

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