Phase III, randomised, double-blind, multicentre study to evaluate the efficacy and safety of vonoprazan compared with lansoprazole in Asian patients with erosive oesophagitis. Issue 2 (13th August 2019)

• Record Type: Journal Article
• Authors: Xiao, Yinglian; Zhang, Shutian; Dai, Ning; Fei, Guijun; Goh, Khean-Lee; Chun, Hoon Jai; Sheu, Bor-Shyang; Chong, Chui Fung; Funao, Nobuo; Zhou, Wen; Chen, Minhu
• Is Part Of: Gut. Volume 69:Issue 2(2020)
• Page Start: 224
• Page End: 230
• Publication Date: 2019-08-13
• Subjects: erosive oesophagitis -- proton pump inhibition -- gastric acid -- gastro-oesophageal reflux disease; Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gutjnl-2019-318365
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Objective: To establish the non-inferior efficacy of vonoprazan versus lansoprazole in the treatment of Asian patients with erosive oesophagitis (EO). Design: In this phase III, double-blind, multicentre study, patients with endoscopically confirmed EO were randomised 1:1 to receive vonoprazan 20 mg or lansoprazole 30 mg, once daily for up to 8 weeks. The primary endpoint was EO healing rate at 8 weeks. The secondary endpoints were EO healing rates at 2 and 4 weeks. Safety endpoints included treatment-emergent adverse events (TEAEs). Results: In the vonoprazan (n=238) and lansoprazole (n=230) arms, 8-week EO healing rates were 92.4% and 91.3%, respectively (difference 1.1% (95% CI –3.822% to 6.087%)). The respective 2-week EO healing rates were 75.0% and 67.8% (difference 7.2% (95% CI –1.054% to 15.371%)), and the respective 4-week EO healing rates were 85.3% and 83.5% (difference 1.8% (95% CI –4.763% to 8.395%)). In patients with baseline Los Angeles classification grade C/D, 2-week, 4-week and 8-week EO healing rates were higher with vonoprazan versus lansoprazole (2 weeks: 62.2% vs 51.5%, difference 10.6% (95% CI –5.708% to 27.002%); 4 weeks: 73.3% vs 67.2%, difference 6.2% (95% CI –8.884 to 21.223); and 8 weeks: 84.0% vs 80.6%, difference 3.4% (95% CI –9.187% to 15.993%)). Overall, EO healing rates appeared higher with vonoprazan versus lansoprazole. TEAE rates were 38.1% and 36.6% in the vonoprazan and lansoprazole group, respectively. Conclusion: Our findings demonstrate the non-inferior efficacy of vonoprazan versus lansoprazole in terms of EO healing rate at 8 weeks in this population. Safety outcomes were similar in the two treatment arms. Trial registration number: NCT02388724 .