Efficacy of on-demand therapy using 20-mg vonoprazan for non-erosive reflux disease
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To evaluate the efficacy of on-demand therapy using 20-mg vonoprazan for non-erosive reflux disease.
On-demand therapy by taking one 20-mg tablet of vonoprazan only when reflux symptoms occurred was performed for 8 weeks by 30 patients (11 men, mean age: 67.8) with non-erosive reflux disease who responded well to maintenance therapy using proton pump inhibitor and answered “very satisfied” or “satisfied” to an overall satisfaction survey (5-grade scale). The degree of overall satisfaction with the treatment, score of symptoms, and fasting gastrin levels before breakfast was examined before and after on-demand therapy. The number of vonoprazan tablets taken and the frequency (regular, temporary, rare) of its administration were also investigated.
All patients completed 8-week on-demand therapy with 20-mg vonoprazan. Comparisons of patient satisfaction levels before and after therapy revealed no significant differences in the number of patients who were very satisfied and satisfied with the therapy. Furthermore, there were no significant differences in score of symptoms or gastrin levels before and after therapy. During 8-week on-demand therapy, patients took 11 tablets (median) (7.0–18.0 tablets: 25–75 percentiles), and 30.0% of patients (n = 9) took vonoprazan on a regular basis (at least 2 tablets a week).
On-demand therapy with 20-mg vonoprazan exerted equivalent effects to continuous PPI maintenance therapy for patients with non-erosive reflux disease.
KeywordsNon-erosive reflux disease Vonoprazan On-demand therapy Maintenance therapy
The authors thank Ms. Satoko Nishimura for administrative assistance.
Compliance with ethical standards
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent or substitute for it was obtained from all patients for being included in the study.
Conflict of interest
Katsuhiko Iwakiri has received lecture fees from Takeda Pharmaceutical Co., Ltd. and Otsuka Pharmaceutical Co., Ltd.. The remaining authors declare that they have no conflicts of interest.
- 6.Kawami N, Takenouchi N, Umezawa M, et al. Pathogenesis of double-dose proton pump inhibitor-resistant non-erosive reflux disease, and mechanism of reflux symptoms and gastric acid secretion-suppressive effect in the presence or absence of Helicobacter pylori infection. Digestion. 2017;95:140–5.CrossRefGoogle Scholar
- 14.Hoshihara Y. Endoscopic findings of GERD. Nihon Rinsho. 2004;62:1459–64.Google Scholar
- 19.Jenkins H, Sakurai Y, Nishimura A, et al. Randomised clinical trial: safety, tolerability, pharmacokinetics and pharmacodynamics of repeated doses of TAK-438 (vonoprazan), a novel potassium-competitive acid blocker, in healthy male subjects. Aliment Pharmacol Ther. 2015;41:636–48.CrossRefGoogle Scholar
- 22.Nagahara A, Hojo M, Asaoka D, et al. A randomized prospective study comparing the efficacy of on-demand therapy versus continuous therapy for 6 months for long-term maintenance with omeprazole 20 mg in patients with gastroesophageal reflux disease in Japan. Scand J Gastroenterol. 2014;49:409–17.CrossRefGoogle Scholar