Editorial: non‐erosive reflux disease (NERD) is often not GERD—time to change the definition or abandon the term? Authors' reply
Abstract
We thank Dr Katz for his indepth commentary on our study evaluating the role of tegoprazan, a novel potassiumcompetitive acid blocker (PCAB), in patients with nonerosive reflux disease (NERD).1,2 NERD has multifactorial pathophysiology and may cause refractory symptoms in a substantial proportion of patients with gastrooesophageal reflux disease (GERD). Therefore, there is still an unmet need for the treatment of the distinct symptom presentations of GERD, especially NERD.3 Another PCAB— vonoprazan— in a dose of 10 mg (lower than the approved therapeutic dose for GERD) was not significantly superior to placebo in improving symptoms in patients with NERD4 and failed to obtain approval for that indication. Tegoprazan has become the first PCAB approved for NERD in Korea. In the study under discussion, tegoprazan was administered at the same dose as in GERD, and its efficacy in patients with NERD was proven. Dr Katz suggested that a significant proportion of patients with NERD do not have reflux episodes that correlate with their symptoms, and predicted that patients with true gastrooesophageal reflux would respond as well to proton pump inhibitors as patients with erosive disease. We agree entirely. In the current study, the effect of tegoprazan was superior in patients with more severe heartburn and in the group given the highest dose. Since NERD is heterogenous and treatment response is relatively low, it reduces the quality of life of patients. Therefore, a more multifaceted…
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