S953 Effectiveness and Safety of Vonoprazan Treatment on Symptoms in Elderly Patients With Reflux Esophagitis in China: Post Hoc Analysis of the VIEW Study

Introduction: Elderly patients are prone to complications of gastroesophageal reflux disease (GERD) including reflux esophagitis (RE), due to physiological changes, comorbidities, and concomitant medications, thereby requiring more effective management. Vonoprazan, a potassium-competitive acid blocker, is recommended as a first-line treatment for RE in China. This post hoc analysis of the VIEW study evaluated the effectiveness and safety of vonoprazan in elderly Chinese patients (≥65 years old) with RE in a real-world setting. Methods: VIEW (NCT04501627) is a multicenter, single-arm, prospective, noninterventional observational study. Patients received vonoprazan (20 mg) for 4 weeks (8 weeks if insufficient benefit), with a 2-week safety follow-up. Mean symptom score changes (least-squares mean [LSM]) from baseline for all-day and nighttime heartburn and regurgitation were evaluated over 14 days using a mixed-effects model for repeated measures. The GERD Questionnaire (GERDQ) assessed changes in symptom frequency, sleep disturbances, and additional medication use over 4 weeks. Incidence of adverse events (AEs) was assessed. Results: Of the 1,796 pts with RE in the effectiveness analysis set, 250 were aged ≥65 years (elderly patients). Vonoprazan significantly reduced mean symptom scores from 1.80 at baseline to 1.13 on day 1 in elderly patients with all-day heartburn and regurgitation, further reducing to 0.41 by day 14 (LSM, day 1: -0.7 [95% confidence interval (CI) -1.0, -0.5]; day 14: -1.5 [95% CI -1.6, -1.3]). Mean scores also reduced significantly for nighttime heartburn, from 1.7 at baseline to 1.1 on day 1 and to 0.4 by day 14 (LSM, day 1: -0.7 [95% CI -0.9, -0.4]; day 14: -1.4 [95% CI -1.6, -1.3]) and for nighttime regurgitation, from 1.7 at baseline to 1.0 on day 1 and to 0.3 by day 14 (LSM, day 1: -0.7 [95% CI -0.9, -0.5]; day 14: -1.3 [95% CI -1.5, -1.2]). The mean (standard deviation) time to the first 24 hours of complete heartburn and regurgitation relief was 4.6 (3.93) days. Elderly patients reporting no heartburn, no regurgitation, no sleep disturbance, and no need for additional medication increased from 35.2% to 73.2%, 28.8% to 68.4%, 53.6% to 83.3%, and 78.4% to 91.3%, respectively, from baseline to week 4. One or more mild, moderate, or severe AEs were reported in 13.7%, 1.9%, and 1.5% of elderly patients (N = 262), respectively. Conclusion: Vonoprazan provided a quick onset of action for symptom relief and was well tolerated in elderly patients with RE.