Comparison of tegoprazan 25 mg vs. lansoprazole 15 mg for mild erosive oesophagitis

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Created On: 03/01/2026

This phase 3 randomized clinical trial determined the effectiveness and safety of tegoprazan (potassium-competitive acid blocker [P-CAB]) vs. lansoprazole (proton pump inhibitor [PPI]) as long-term maintenance therapy in patients with previously healed erosive oesophagitis.

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Key take away

Tegoprazan 25 mg maintains healed erosive oesophagitis as effectively and safely as lansoprazole 15 mg, showing non-inferiority in remission rates at 12 and 24 weeks.

Background

Method

Participants with endoscopically confirmed healed erosive oesophagitis were randomly allocated to get once-daily tegoprazan 25 mg or lansoprazole 15 mg for 24 weeks. The outcomes were as follows:

Primary outcome: Endoscopic remission rate at week 24
Secondary outcome: Endoscopic remission rate at week 12
Safety outcomes: Adverse events, laboratory parameters, and changes in serum gastrin and pepsinogen I/II levels

Result

A total of 351 patients were enrolled (tegoprazan: n=174; lansoprazole: n=177). Most participants presented with mild disease (Los Angeles [LA] grade A: 57.3%; LA grade B: 37.3%). In terms of endoscopic remission rate, tegoprazan demonstrated non-inferiority to lansoprazole at both week 12 and week 24 (Table 1).

Subgroup findings showed no significant differences based on LA grade (p = 0.47) or CYP2C19 metabolic status (p = 0.76). Serum gastrin increases were comparable between both treatment groups.

Conclusion

Tegoprazan 25 mg proved non-inferior to lansoprazole 15 mg as a maintenance therapy for healed erosive oesophagitis, demonstrating high remission rates at both 12 and 24 weeks. The drug showed consistent performance across metabolic and disease severity subgroups, with a safety profile comparable to standard PPI therapy.