Vonoprazan use is associated with lower hospitalization and bleeding rates in patients with erosive esophagitis compared to proton pump inhibitors: a real-world analysis.

OBJECTIVES

Vonoprazan, is non-inferior to proton pump inhibitors (PPIs) for erosive esophagitis in randomized studies. Large-scale comparative studies between vonoprazan and PPIs in erosive esophagitis remain limited.

METHODS

Using the TriNetX Global Network, we retrospectively identified 103,945 adults with erosive esophagitis, including 1,452 on vonoprazan which were compared to 1,448 PPI users by propensity matching (1:1).

RESULTS

At 90 days, vonoprazan was associated with reduced hospitalizations (HR 0.28), bleeding (HR:0.36), and AKI (HR:0.17), without differences in C. difficile infection, pneumonia, dysphagia, or diarrhea.

CONCLUSION

Real world evidence suggest vonoprazan improves clinical outcomes with similar tolerability than PPI therapy for erosive esophagitis.