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Review
. 2025 Jul;85(7):945-955.
doi: 10.1007/s40265-025-02193-x. Epub 2025 May 19.

Vonoprazan: A Review in Erosive Esophagitis and Non-Erosive Gastro-Esophageal Reflux Disease

Simon Fung  1
Affiliations
Review

Vonoprazan: A Review in Erosive Esophagitis and Non-Erosive Gastro-Esophageal Reflux Disease

Simon Fung. Drugs. 2025 Jul.

Abstract

Vonoprazan (Voquezna®) is a potassium-competitive acid blocker (PCAB) with improved pharmacodynamic and pharmacokinetic properties compared with proton-pump inhibitors (PPIs) that allow for stronger control of gastric acid with once-daily oral administration and no requirement to be taken in relation to timing of meals for optimal efficacy. In the USA, vonoprazan has been approved as a first-in-class treatment for healing and maintenance of healing of erosive esophagitis, and for relief of heartburn in adult patients with erosive esophagitis and non-erosive gastro-esophageal reflux disease (GERD). In pivotal phase III trials, vonoprazan was non-inferior to the PPI lansoprazole in healing and superior to lansoprazole in maintenance of healing of erosive esophagitis, and was superior to placebo for treating heartburn in US patients with non-erosive GERD. Vonoprazan was generally well tolerated; the most common adverse events included abdominal pain, constipation, diarrhea, nausea, and dyspepsia. Vonoprazan is, therefore, a valuable addition to the therapies available for adults with erosive esophagitis and non-erosive GERD.

Plain language summary

Gastro-esophageal reflux disease (GERD) is typically associated with heartburn and regurgitation. If left untreated, it can increase the risk of serious complications through to esophageal cancer. GERD is treated with gastric acid-suppressing agents; however, patients can relapse or have incomplete symptom relief with traditional treatments. Vonoprazan (Voquezna®) is the first drug in a new class of acid-suppressing agents, potassium-competitive acid blockers (PCABs), to be approved in the USA and provides durable control of gastric acid with once-daily oral administration and can be taken with or without food. Vonoprazan was approved for treatment of erosive esophagitis and non-erosive GERD in the USA following clinical trials that demonstrated the non-inferiority of vonoprazan to the proton pump inhibitor lansoprazole in healing and superiority to lansoprazole in maintenance of healing of erosive esophagitis, and superiority to placebo for treating heartburn in patients with non-erosive GERD. Vonoprazan was generally well tolerated in clinical trials, with gastrointestinal symptoms being the most common adverse events. Thus, vonoprazan represents a valuable additional option to the acid-suppressing agents available for adults with erosive esophagitis and non-erosive GERD.

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Conflict of interest statement

Declarations. Funding: The preparation of this review was not supported by any external funding. Authorship and Conflict of Interest: Simon Fung is a salaried employee of Adis International Ltd/Springer Nature, and declares no relevant conflicts of interest. All authors contributed to this article and are responsible for its content. Ethics Approval, Consent to Participate, Consent to Publish, Availability of Data and Material, Code Availability: Not applicable.

References

    1. Katz PO, Dunbar KB, Schnoll-Sussman FH, et al. ACG clinical guideline for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2022;117(1):27–56. - PubMed - PMC
    1. Tack J, Pandolfino JE. Pathophysiology of gastroesophageal reflux disease. Gastroenterology. 2018;154(2):277–88. - PubMed
    1. Ravindran A, Iyer PG. Gastroesophageal reflux disease and complications. In: Pitchumoni C, Dharmarajan T, editors. Geriatric gastroenterology. Cham: Springer; 2020.
    1. Lundell LR, Dent J, Bennett JR, et al. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut. 1999;45(2):172–80. - PubMed - PMC
    1. Dickman R, Maradey-Romero C, Gingold-Belfer R, et al. Unmet needs in the treatment of gastroesophageal reflux disease. J Neurogastroenterol Motil. 2015;21(3):309–19. - PubMed - PMC

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