Clinical efficacy and failure factors of vonoprazan compared with esomeprazole in the treatment of reflux esoph-agitis
LI Meng-ling
LIAN Huo-jun
LI Jun
Abstract：Objective To investigate the clinical efficacy of vonoprazan and esomeprazole in the treatment of re-flux esophagitis and analysis of risk factors for treatment failure.Methods One hundred patients with reflux esophagitis were selected for the study.Among them,50 patients were treated with vonoprazan and the other 50 patients were treated with esomeprazole.After 4 and 8 weeks of treatment,gastroscopy was performed to evaluate the efficacy,and clinical symptom scores were used to assess the efficacy.Patients who failed to respond to treatment at week 8 underwent drug crossover treatment until week 12,and efficacy was evaluated by gastroscopy.Finally,patients were divided into treatment failure group and success group based on the gastroscopy evaluation at 8 weeks,and risk factors for treatment failure were analyzed using univariate and multivariate analyses.Results Significant differences were found in the efficacy of vono-prazan and esomeprazole groups at 4 weeks(P＜0.05)and 8 weeks(P＜0.05)based on clinical symptom scores and gastroscopy evaluation.The total effective rate of patients who switched to vonoprazan after crossover treatment was 64.71％,while that of patients who switched to esomeprazole was 14.29％,and the difference between the groups was statistically significant(P＜0.05).Treatment failure was not associated with gender,age,smoking history,or family his-tory(P＞0.05),but was associated with body mass index ≥24 kg/m2,pre-bedtime eating,alcohol consumption,H.pylori infection,disease severity,and treatment drugs,with statistically significant differences between the groups(P＜0.05).Multivariate logistic regression analysis showed that body mass index ≥ 24 kg/m2,pre-bedtime eating,disease severity,and treatment drugs were risk factors for treatment failure.Conclusion Vonoprazan is effective in the treatment of reflux esophagitis and is superior to esomeprazole.Risk factors for treatment failure include body mass index ≥24 kg/m2,alcohol consumption,severity of lesions,and pre-bedtime eating.
Keywords：reflux esophagitisvonoprazanesomeprazoleefficacy analysis
Publication Date：2024-04-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 472-478 )