Efficacy and Gastrin Levels in Gastroesophageal Reflux Disease Patients Treated with Esomeprazole Following a Potassium‒competitive Acid Blocker

Abstract

Background：Changing a drug from a potassium‒competitive acid blocker（P‒CAB） to a proton pump inhibitor（PPI）is one of the treatment options for long‒term management of gastroesophageal reflux disease（GERD）. GERD symptoms and serum gastrin levels were investigated in reflux esophagitis（RE）patients who switched from potassium‒competitive acid blocker to esomeprazole. Methods：Esomeprazole 20 mg was orally administered to RE patients who had been treated with vonoprazan 20 mg once daily for more than 4 weeks. Primary endpoint was changes in the total scores at Week 4 based on the Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease（FSSG）questionnaire. The secondary endpoints were changes in the reflux scores, motility scores, and total scores evaluated based on the FSSG questionnaire, changes in serum gastrin levels, and tolerability.Results：In 25 patients with mean age of 60.5 years, median FSSG total score demonstrated a significant decrease both at Week 2（p＜0.05）and Week 4（p＜0.01）. Median FSSG reflux score demonstrated a significant decrease both at Week 2（p＜0.01）and Week 4（p＜0.001）. Median FSSG motility scores showed no statistical significance at any time. Median serum gastrin level significantly decreased from 755 pg/mL at baseline to 309 pg/mL at Week 4（p＜0.01）.Conclusion：Treatment with esomeprazole in patients with GERD was suggested to be a useful option both in management of GERD symptom and serum gastrin level.