Efficacy of Vonoprazan for Proton Pump Inhibitor-Resistant Reflux Esophagitis
Efficacy of Vonoprazan for Proton Pump Inhibitor-Resistant Reflux Esophagitis
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DOI：
10.1159/000456072
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发表时间：
2017-01-01
期刊：
影响因子：
3.2
通讯作者：
Iwakiri, Katsuhiko
中科院分区：
文献类型：
--
作者：
Hoshino, Shintaro;Kawami, Noriyuki;Iwakiri, Katsuhiko
背景资料：沃诺拉赞（VPZ）是一种新型钾竞争性酸阻滞剂，可能对质子泵抑制剂（PPI）耐药反流性食管炎（RE）具有临床获益。本研究的目的是研究VPZ 20 mg治疗4周对PPI耐药RE患者的疗效，以及VPZ 10 mg维持治疗8周对已成功治疗的患者的疗效。方法：受试者包括24例PPI耐药RE患者（洛杉矶分类A/B/C/D级：3/7/11/3）。在通过内窥镜检查确认PPI耐药RE后，给予20 mg VPZ。在VPZ开始后4周进行内窥镜检查。使用胃食管反流病（FSSG）症状的频率量表评估症状。给予VPZ 10 mg维持治疗，8周后进行内镜检查。结果：24例患者中，21例（87.5%）食管粘膜破裂用VPZ 20 mg治疗成功。在开始VPZ给药后第1-7、14和28天，中位FSSG评分显著低于给药前。21例患者中，16例（76.2%）使用10 mg VPZ维持治疗预防了食管粘膜破裂的复发。结论：VPZ对PPI耐药RE患者疗效显著。(C)2017 S. Karger AG，巴塞尔
Background: Vonoprazan (VPZ) is a novel potassium-competitive acid blocker that may be clinically beneficial for proton pump inhibitor (PPI)-resistant reflux esophagitis (RE). The aim of this study was to investigate the efficacies of VPZ therapy at 20 mg for 4 weeks in patients with PPI-resistant RE and VPZ maintenance therapy at 10 mg for 8 weeks in patients who have been successfully treated. Methods: Subjects comprised 24 patients with PPI-resistant RE (Los Angeles classification grade A/B/C/D: 3/7/11/3). After confirming PPI-resistant RE by endoscopy, 20 mg VPZ was administered. Endoscopy was performed 4 weeks after the initiation of VPZ. Symptoms were evaluated using the frequency scale for the symptoms of gastroesophageal reflux disease (FSSG). Maintenance therapy with 10 mg VPZ was performed and endoscopy was conducted after 8 weeks. Results: In 21 (87.5%) out of 24 patients, esophageal mucosal breaks were successfully treated by 20 mg VPZ. The median FSSG score was significantly lower on days 1-7, 14, and 28 after the initiation of VPZ than before its administration. Maintenance therapy with 10 mg VPZ prevented the relapse of esophageal mucosal breaks in 16 (76.2%) out of 21 patients. Conclusion: VPZ was effective for most patients with PPI-resistant RE. (C) 2017 S. Karger AG, Basel