Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jan 6;15(1):19.
doi: 10.3390/jpm15010019.

Preference for On-Demand Fexuprazan Therapy in Gastroesophageal Reflux Disease: A Prospective Cohort Study

Affiliations

Preference for On-Demand Fexuprazan Therapy in Gastroesophageal Reflux Disease: A Prospective Cohort Study

Byung Wook Jung et al. J Pers Med. .

Abstract

Introduction: Maintenance therapy is crucial in managing and preventing symptom relapse in gastroesophageal reflux disease (GERD), with continuous and on-demand therapy being the common approaches. However, maintenance therapy using potassium-competitive acid blockers (P-CABs), such as fexuprazan, remains incompletely evaluated. Methods: This single-center, single-arm, prospective cohort study enrolled individuals with weekly heartburn or acid regurgitation and confirmed erosive esophagitis. The participants received 40 mg fexuprazan daily for 4 weeks as initial therapy, followed by 4 weeks of maintenance therapy. Patients chose either continuous or on-demand therapy for maintenance, according to their preference. The primary endpoint was the proportion of patients selecting on-demand therapy. The symptom scores were assessed using the GERD questionnaire (GERD-Q) and patient assessment of upper-gastrointestinal-disorders symptoms questionnaire (PAGI-SYM). Results: The 31 included participants showed a significant reduction in symptom scores after initial treatment (baseline vs. 4-week: GERD-Q, 9.0 vs. 6.5, p < 0.001; PAGI-SYM, 29.0 vs. 10.8, p < 0.001). Twenty-one (67.7%) patients chose on-demand therapy after initial treatment. The symptom scores did not differ significantly before and after maintenance therapy (4-week vs. 8-week: GERD-Q, 6.5 vs. 6.0, p = 0.225; PAGI-SYM, 10.8 vs. 9.0, p = 0.354). Although this relation was not significant, patients experiencing larger decreases in symptom scores tended to prefer on-demand therapy. After maintenance therapy, the symptom scores did not differ between continuous and on-demand therapy (GERD-Q, 5.3 vs. 6.3, p = 0.342; PAGI-SYM, 9.4 vs. 8.8, p = 0.611). Conclusions: Fexuprazan was effective as an initial and maintenance therapy in patients with GERD who showed typical symptoms. Approximately 68% of the patients preferred on-demand therapy as a maintenance treatment. Based on the patient's preference for maintenance therapy, symptom control did not differ between continuous and on-demand therapy.

Keywords: fexuprazan; gastroesophageal reflux disease; maintenance therapy.

PubMed Disclaimer

Conflict of interest statement

C.H.P. received research funding related to this study from Daewoong Pharmaceutical company. The Daewoong Pharmaceutical company was not involved in the design of this study, its conduction and analysis, or the interpretation of study results.

Figures

Figure 1
Figure 1
Study flow diagram. On-demand therapy was defined as consuming <80% of prescribed medication. GERD-Q, gastroesophageal reflux disease questionnaire; PAGI-SYM, patient assessment of upper-gastrointestinal-disorders symptoms questionnaire.
Figure 2
Figure 2
Changes in GERD-Q and PAGI-SYM scores. Each dot represents a study participant, with orange indicating the baseline, cyan representing the 4-week point, and purple denoting the 8-week point. GERD-Q, gastroesophageal reflux disease questionnaire; PAGI-SYM, patient assessment of upper-gastrointestinal-disorders symptoms questionnaire.
Figure 3
Figure 3
Medication adherence rate during maintenance therapy. Continuous and on-demand therapies were allowed during maintenance therapy. On-demand therapy was defined as consuming <80% of prescribed medication. Each dot represents a study participant, with orange indicating those who received continuous therapy and cyan representing those who received on-demand therapy.
Figure 4
Figure 4
Changes in heartburn and regurgitation frequency scores of GERD-Q. Left panel (A) is color-coded based on baseline scores (range: 0–6); right panel (B) is color-coded based on preference for maintenance therapy. In the left panel, the different colors represent the GERD-Q scores at the baseline. In the right panel, orange represents continuous therapy and green represents on-demand therapy. Y-axis indicates heartburn and regurgitation frequency scores. GERD-Q, gastroesophageal reflux disease questionnaire.

References

    1. Jung H.K., Tae C.H., Song K.H., Kang S.J., Park J.K., Gong E.J., Shin J.E., Lim H.C., Lee S.K., Jung D.H., et al. 2020 Seoul Consensus on the Diagnosis and Management of Gastroesophageal Reflux Disease. J. Neurogastroenterol. Motil. 2021;27:453–481. doi: 10.5056/jnm21077. - DOI - PMC - PubMed
    1. Hunt R., Armstrong D., Katelaris P., Afihene M., Bane A., Bhatia S., Chen M.H., Choi M.G., Melo A.C., Fock K.M., et al. World Gastroenterology Organisation Global Guidelines: GERD Global Perspective on Gastroesophageal Reflux Disease. J. Clin. Gastroenterol. 2017;51:467–478. doi: 10.1097/MCG.0000000000000854. - DOI - PubMed
    1. Van Soest E.M., Siersema P.D., Dieleman J.P., Sturkenboom M.C., Kuipers E.J. Persistence and adherence to proton pump inhibitors in daily clinical practice. Aliment. Pharmacol. Ther. 2006;24:377–385. doi: 10.1111/j.1365-2036.2006.02982.x. - DOI - PubMed
    1. Bayerdorffer E., Bigard M.A., Weiss W., Mearin F., Rodrigo L., Dominguez Munoz J.E., Grundling H., Persson T., Svedberg L.E., Keeling N., et al. Randomized, multicenter study: On-demand versus continuous maintenance treatment with esomeprazole in patients with non-erosive gastroesophageal reflux disease. BMC Gastroenterol. 2016;16:48. doi: 10.1186/s12876-016-0448-x. - DOI - PMC - PubMed
    1. Cho J.H., Koo J.Y., Kim K.O., Lee S.H., Jang B.I., Kim T.N. On-demand versus half-dose continuous therapy with esomeprazole for maintenance treatment of gastroesophageal reflux disease: A randomized comparative study. Medicine. 2018;97:e12732. doi: 10.1097/MD.0000000000012732. - DOI - PMC - PubMed

LinkOut - more resources