Efficacy of Vonoprazan for 48-Week Maintenance Therapy of Patients with Healed Reflux Esophagitis

Digestion. 2020;101(4):411-421. doi: 10.1159/000500399. Epub 2019 May 24.


Aims: We aimed to evaluate the efficacy of vonoprazan (VPZ) as maintenance therapy for healed reflux esophagitis (RE).

Methods: We enrolled 74 patients diagnosed with RE with frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) total score ≥8 after at least 8 weeks of treatment with standard proton pump inhibitors (PPIs). These patients were switched to VPZ 20 mg for 4 weeks. We also enrolled 71 patients with no endoscopic evidence of erosive esophagitis who received maintenance therapy with VPZ 10 mg for 48 weeks. The primary end point was the proportion of patients who maintained healed RE refractory to PPIs after 48 weeks of maintenance therapy with on demand 10 mg VPZ. Secondary assessment included the proportion of patients with symptomatic nonrelapse at 48 weeks.

Results: Fifty patients successfully completed 48-week maintenance therapy. Maintenance therapy with VPZ 10 mg prevented the relapse of esophageal mucosal breaks in 43 (86.0%) of 50 patients at 48 weeks. During the 48-week maintenance therapy, symptomatic nonrelapse rate for acid reflux-related symptom score of FSSG and acid reflux score of Gastrointestinal Symptom Rating Scale at 48 weeks were 70.0 and 72.0%, respectively. No serious adverse events were reported during the study.

Conclusion: VPZ 10 mg is clinically effective for maintenance of healed RE for 48 weeks.

Keywords: Gastroesophageal reflux disease; Maintenance therapy; Reflux esophagitis refractory to proton pump inhibitors; Vonoprazan.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Drug Administration Schedule
  • Esophageal Mucosa / pathology
  • Esophagitis, Peptic / drug therapy*
  • Esophagitis, Peptic / pathology
  • Female
  • Humans
  • Maintenance Chemotherapy / methods*
  • Male
  • Middle Aged
  • Proton Pump Inhibitors / therapeutic use
  • Pyrroles / administration & dosage*
  • Recurrence
  • Severity of Illness Index
  • Sulfonamides / administration & dosage*
  • Treatment Outcome


  • 1-(5-(2-fluorophenyl)-1-(pyridin-3-ylsulfonyl)-1H-pyrrol-3-yl)-N-methylmethanamine
  • Proton Pump Inhibitors
  • Pyrroles
  • Sulfonamides