Work

Comparison of Fexuprazan and Esomeprazole for the Control of Nocturnal Gastroesophageal Reflux Symptoms: A Randomized, Crossover Study

Year: 2025

Type: article

Study designs: Randomized Controlled Trial, Clinical Trial

Abstract: Background/AimsNocturnal acid reflux disrupts sleep and impairs quality of life.Proton pump inhibitors (PPIs) provide insufficient suppression of nocturnal acid secretion, whereas fexuprazan offers prolonged acid suppression.We compared the efficacy of fexuprazan and esomeprazole in controlling nocturnal reflux. MethodsIn a randomized and crossover study, patients received fexuprazan or esomeprazole daily for 4 weeks, followed by a washout and crossover to the alternate medication for another 4 weeks, with a final washout completing the sequence.Severity (scores 0-10), frequency, sleep disturbance, and medication preferences were evaluated. ResultsThirty-nine patients were enrolled and randomized to receive either fexuprazan (n = 20) or esomeprazole (n = 19) first.After the first treatment, fexuprazan reduced severity from 7.5 ± 1.2 to 1.4 ± 1.0 (81% decrease), versus 7.5 ± 1.1 to 2.8 ± 1.5 (64% decrease) with esomeprazole (p = 0.012).In patients with severe symptoms (scores ≥ 7), fexuprazan led to significantly greater improvement than esomeprazole (p = 0.008).Following the first washout, the second crossover treatment resulted in greater improvement in symptom severity with fexuprazan (p = 0.001).During the second washout, nocturnal symptoms severity and frequencies were better controlled with fexuprazan than with esomeprazole (p = 0.005 and 0.019).Patients who switched from esomeprazole to fexuprazan preferred fexuprazan (p = 0.018).A h e a d o f P r i n t 3 Conclusions Fexuprazan was more effective than esomeprazole in controlling nocturnal reflux symptom, particularly in patients with severe symptoms.Fexuprazan may offer a therapeutic advantage for patients with severe and persistent nocturnal reflux despite PPI therapy..

Source: Journal of Neurogastroenterology and Motility

DOI: 10.5056/jnm25119

Authors: Dong Jun Oh, Dong Hwan Park, Jiyun Jung, Yun Jeong Lim

Institutions: Dongguk University Ilsan Hospital, Dongguk University

Language: English

Topic: Gastroesophageal reflux and treatments

Subfield: Gastroenterology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

Funders: Dongguk University, Daewoong Pharmaceutical Company