Efficacy of tapering (STEP down) therapy using vonoprazan for symptomatic mild reflux esophagitis

Abstract

Abstract Aim: This study aimed to elucidate the efficacy of tapering (STEP down) therapy based on patients’ symptoms using vonoprazan (VPZ) for symptomatic mild reflux esophagitis (RE). Methods: Sixty-three consecutive symptomatic patients with mild RE were enrolled in this study. STEP down therapy was defined as a treatment period of 28 days. VPZ (20 mg) was administered as initial treatment. Patients were allowed to step down to 10 mg VPZ if their symptoms improved, and may discontinue VPZ if their symptoms disappeared. When symptoms worsened, dosage could be increased from 10 mg to 20 mg VPZ, or VPZ restarted at 20 mg following discontinuation. Results: The proportion of the patients whose FSSG scores decreased by three points or more with STEP down therapy was 76.2% (48/63 patients). The median FSSG scores before and after STEP down therapy were 13 (8–35) and 7 (0–29) points, respectively (p<0.01). Overall, 71.4% (45/63) of patients stepped down from 20 mg to 10 mg VPZ, and 46% (29/63) of patients discontinued VPZ. Conclusion: STEP down therapy with VPZ may be a viable treatment option in symptomatic patients with mild RE.