For gastroesophageal reflux disease (GERD) management, Vonoprazan and Esomeprazole were shown to have equivalent safety and effectiveness in a randomized phase 2 clinical study. Jan Tack et al. compared the effectiveness of potassium-competitive acid blocker versus proton-pump inhibitor (PPI) in preventing heartburn symptoms in GERD patients who had a partial response to Esomeprazole throughout the course of a 4-week therapy period.

Overall, 256 patients (mean age 52.6 years; females, 59.4%) who had GERD symptoms and a partial response to a healing dosage of Esomeprazole were randomly assigned to receive Vonoprazan 20 mg once a day (q.d.) (n = 85) and 40 mg (n = 85) vs. Esomeprazole 40 mg q.d (n = 86). Regarding the mean (standard deviation [SD]) percentage of heartburn-free 24-hour periods, there was no intergroup statistical significance, as depicted in Table 1:

From a dose of 20 mg to a dose of 40 mg, Vonoprazan exposure rose proportionately (mean Cmax: 23.3 ng/ml to 47.1 ng/ml, respectively). No fatalities were witnessed, and the majority of treatment-emergent adverse events were reported to be mild. Vonoprazan was well-tolerated, and there was no clinically meaningful difference across treatment groups in terms of safety and effectiveness.