A study illustrated that in patients with GERD, vonoprazan, a new potassium-competitive acid blocker launched in Japan, is non-inferior to PPIs. However, vonoprazan demonstrated more efficacy than PPIs for patients having severe erosive esophagitis in the subgroup analysis. Both vonoprazan and PPIs have similar safety outcomes.

A meta-analysis was carried out to compare the therapeutic effects and adverse events between PPI and 20 mg vonoprazan therapy in GERD patients. The literature sources used were Embase, MEDLINE, and the Cochrane Central Register of Controlled Trials. For 20 mg vonoprazan and PPIs, randomized controlled trials published in English were extensively searched.

Two researchers individually extracted the data from studies meeting the eligibility criteria  and were compared to maintain consistency. Overall, 56 articles were identified in the databases, one study was manually searched and added to the analysis, ultimately providing six eligible studies. For the main analysis, the risk ratios (RR) of efficacy and adverse events between vonoprazan and PPIs is depicted in the following table:

For patients with severe esophagitis at baseline, the subgroup analysis illustrated considerably higher results for vonoprazan in comparison with lansoprazole, with an RR of 1.14. As per study authors, further direct head-to-head comparison trials of PPIs and vonoprazan are required to validate the safety and efficacy of treatment in GERD patients.

Thus, in GERD patients, vonoprazan is non-inferior to PPIs and has similar safety outcomes as PPIs.