Factors Associated with Potassium-Competitive Acid Blocker Non-Response in Patients with Proton Pump Inhibitor-Refractory Gastroesophageal Reflux Disease

Digestion
Masatsugu OkuyamaYasuhiro Fujiwara

Abstract

Approximately 20-40% of patients with gastroesophageal reflux disease (GERD) are refractory to proton pump inhibitor (PPI) treatment. The acid-inhibitory effect of vonoprazan, a novel potassium-competitive acid blocker (P-CAB), is significantly greater when compared to the effect of PPIs. We investigated the efficacy of vonoprazan treatment for PPI-refractory GERD and factors associated with P-CAB non-response. We enrolled 277 GERD patients receiving continuous PPI therapy. Subjects completed a self-report questionnaire including the frequency scale for the symptoms of GERD (FSSG). Patients with PPI-refractory GERD received 20 mg of vonoprazan once daily for 8 weeks. After that, subjects completed the same questionnaire, and the results were used to identify P-CAB responders and non-responders. Twenty-eight patients were identified as P-CAB responders and 26 were non-responders. Vonoprazan treatment significantly decreased scores of FSSG, nighttime symptom, and Athens Insomnia Scale. Multivariate analysis demonstrated co-existing functional dyspepsia (FD; OR 4.94) and the presence of sleep disturbances (OR 4.34) was associated with P-CAB non-response, whereas alcohol consumption was inversely associated. Vonoprazan treatment mi...Continue Reading

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Citations

Mar 8, 2018·Digestion·Mariko UmezawaKatsuhiko Iwakiri
Mar 19, 2019·Journal of Gastroenterology and Hepatology·Hirota MiyazakiToshiro Tango
Jan 26, 2020·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Yuto Shimamura, Haruhiro Inoue
Sep 8, 2020·Expert Opinion on Pharmacotherapy·Nicolas ChapelleMarc Bardou
Jan 9, 2018·Digestion·Akiko ShiotaniTakashi Sakakibara
Apr 3, 2019·Journal of Clinical Biochemistry and Nutrition·Shuichi MiyamotoNaoya Sakamoto
Jan 3, 2019·Esophagus : Official Journal of the Japan Esophageal Society·Yoshimasa HoshikawaKatsuhiko Iwakiri

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