Background: Erosive gastroesophageal reflux disease is a chronic disorder in which the reflux of gastric contents causes visible damage to the esophageal mucosa, leading to symptoms such as heartburn, regurgitation, and retrosternal pain. Proton pump inhibitors such as Esomeprazole are the mainstay of therapy, while Vonoprazan, a potassium-competitive acid blocker, is a newer agent with promising pharmacological properties. Comparative evidence between these two therapies remains limited in regional populations. Objective: To compare the efficacy of Esomeprazole and Vonoprazan in patients with erosive gastroesophageal reflux disease using the Gastroesophageal Reflux Disease Questionnaire. Study Design: Randomized controlled trial. Duration and Place of Study: This study was conducted from May 2024 to October 2024 at the Department of General Medicine, Combined Military Hospital, Rawalakot, Azad Kashmir. Methodology: Sixty patients with endoscopically confirmed erosive gastroesophageal reflux disease were randomly allocated into two equal groups. Group A received esomeprazole 20 milligrams once daily, while Group B received Vonoprazan 20 milligrams once daily for four weeks. Treatment efficacy was defined as sufficient relief, corresponding to a Gastroesophageal Reflux Disease Questionnaire score of one or less after four weeks of therapy. Results: Esomeprazole achieved superior efficacy compared to Vonoprazan, with 93.3% versus 60% of patients attaining sufficient relief (p=0.005). Subgroup analyses demonstrated consistent benefits of esomeprazole in younger patients, males, non-smokers, and obese individuals. Conclusion: Esomeprazole showed greater therapeutic efficacy than Vonoprazan in patients with erosive gastroesophageal reflux disease.
Baig et al. (Fri,) studied this question.