Comparing vonoprazan to high-dose proton pump inhibitors for refractory gastroesophageal reflux disease
Abstract
Background: Gastroesophageal reflux disease (GERD) is a common chronic gastrointestinal disorder that significantly affects quality of life. Although proton pump inhibitors (PPIs) remain the primary pharmacological therapy, a considerable proportion of patients continue to experience persistent symptoms despite optimized or high-dose treatment, resulting in refractory GERD. Potassium-competitive acid blockers, particularly vonoprazan, have recently emerged as an alternative therapeutic option capable of producing rapid and sustained gastric acid suppression. Objective: To compare the effectiveness of vonoprazan with high-dose proton pump inhibitors in achieving sustained symptomatic remission among patients with refractory gastroesophageal reflux disease. Methods: A prospective randomized comparative study was conducted over four months in gastroenterology clinics in the Islamabad–Rawalpindi region. Adult patients with persistent reflux symptoms despite twice-daily high-dose PPI therapy were enrolled and randomly assigned to receive either vonoprazan (20 mg once daily) or continued high-dose PPI therapy. Symptom severity and disease-related quality of life were assessed using validated instruments including the Reflux Disease Questionnaire (RDQ) and the Gastroesophageal Reflux Disease–Health-Related Quality of Life (GERD-HRQL) questionnaire at baseline and during follow-up. Sustained symptomatic remission and time to remission were evaluated. Data were analyzed using…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 72 participants or records.
Read the paper
Related studies
- Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARS-CoV-2: an observational cohort study
- Treatment and prognostic factors for long-term outcome in patients with anti-N-Methyl-D-Aspartate (NMDA) receptor encephalitis: a cohort study
- Effectiveness of mRNA BNT162b2 COVID-19 vaccine up to 6 months in a large integrated health system in the USA: a retrospective cohort study
- Postsurgical prescriptions for opioid naive patients and association with overdose and misuse: retrospective cohort study
- Ethnic and socioeconomic differences in SARS-CoV-2 infection: prospective cohort study using UK Biobank
- Timing of high-efficacy therapy for multiple sclerosis: a retrospective observational cohort study
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.