{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T20:51:48Z","timestamp":1785099108536,"version":"3.55.0"},"reference-count":42,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,9,30]],"date-time":"2022-09-30T00:00:00Z","timestamp":1664496000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Proton\u2010pump inhibitors (PPIs) are cornerstone treatments for gastro\u2010esophageal reflux disease (GERD); however, evidence suggests that most patients exhibit partial response to PPIs, suggesting the need for novel therapies that can provide an improved and sustained increase in gastric pH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This study aimed to determine the effect of vonoprazan, a novel, orally active small\u2010molecule potassium\u2010competitive acid blocker, versus esomeprazole, a PPI, in preventing heartburn symptoms over a 4\u2010week treatment period in patients with GERD and a partial response to esomeprazole treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This randomized, double\u2010blind, proof\u2010of\u2010concept, phase 2 clinical trial was conducted between 2016 and 2018 at 39 sites across Europe and designed to evaluate the efficacy and safety of vonoprazan 20\u2009mg once daily (q.d.) and 40\u2009mg q.d. versus esomeprazole 40\u2009mg q.d. after 1:1:1 randomization of symptomatic patients with GERD and a partial response to a healing dose of esomeprazole.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 256 eligible patients (female, 59.4%; mean age, 52.6\u2009years) received vonoprazan 20\u2009mg (<jats:italic>n<\/jats:italic>\u00a0=\u200985), vonoprazan 40\u2009mg (<jats:italic>n<\/jats:italic>\u00a0=\u200985), or esomeprazole 40\u2009mg (<jats:italic>n<\/jats:italic>\u00a0=\u200986); mean (<jats:italic>SD<\/jats:italic>) percentages of heartburn\u2010free 24\u2010h periods during double\u2010blind treatment were 36.7% (33.4%), 36.5% (35.6%), and 38.4% (34.8%), respectively, with no intergroup statistical significance. Vonoprazan exposure increased proportionally from the 20\u2010mg to 40\u2010mg dose (mean C<jats:sub>max<\/jats:sub>: 23.3\u00a0ng\/ml to 47.1\u00a0ng\/ml, respectively). Most treatment\u2010emergent adverse events were mild, with no deaths reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>No statistically significant difference in efficacy and safety was observed among treatment groups, and vonoprazan was well tolerated. 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