S954 Impact of Patient and Disease Characteristics on the Effectiveness of Vonoprazan in Chinese Patients With Reflux Esophagitis: Post-Hoc Analysis of the Multicenter Prospective VIEW Study

Introduction: Vonoprazan, a potassium-competitive acid blocker, is approved in China as a first-line treatment for reflux esophagitis (RE). The impact of patient and disease characteristics on vonoprazan treatment outcomes is unclear. This post hoc analysis of the VIEW study evaluated its effectiveness in real-world settings in Chinese patients. Methods: VIEW (NCT04501627) was a multicenter, single-arm, noninterventional observational study. All enrolled patients (aged ≥18 years) received standard vonoprazan treatment (20 mg) for 4 weeks (8 weeks if insufficient benefit). This post hoc analysis of patients with RE assessed changes in the gastroesophageal reflux disease questionnaire (GERDQ) frequency score for heartburn and regurgitation, sleep disturbances, and additional medication use (such as TUMS, Rolaids, Maalox) from baseline to week 4, for all patients and by age group (< or ≥65 years), RE severity (mild/severe), and hiatal hernia size (< or ≥2 cm). Results: Among the 1,877 patients included in the RE safety analysis population, mean (standard deviation [SD]) age was 49.7 (13.4) years and body mass index (SD) was 24.1 (3.5) kg/m2; 64.4% were men. The mean (SD) heartburn frequency score decreased from 1.3 (1.20) at baseline to 0.5 (0.84) at week 4 (mean change: -0.8; 95% confidence interval [CI] -0.90, -0.78); the regurgitation frequency score decreased from 1.4 (1.16) at baseline to 0.6 (0.91) at week 4 (mean change: -0.8; 95% CI -0.83, -0.71); difficulty getting good night’s sleep due to heartburn/regurgitation decreased from 0.9 (1.09) at baseline to 0.3 (0.70) at week 4 (mean change: -0.6; 95% CI -0.61, -0.50); and the frequency of taking additional medication for heartburn/regurgitation decreased from 0.5 (0.96) at baseline to 0.1 (0.54) at week 4 (mean change: -0.3; 95% CI -0.38, -0.28). Improvements in symptom frequencies persisted across the subgroup categories by age, RE severity, and hiatal hernia size. Improvement in additional medication use was numerically greater in patients with mild vs severe RE, and similar in ≥65- vs <65-year-olds. However, for all other symptoms, a trend of numerically higher improvement was observed among the elderly (vs those <65 years) and those with severe (vs mild) RE and larger (≥2 cm) hiatal hernia size (vs <2 cm). Conclusion: This subgroup analysis demonstrated that vonoprazan effectively provided symptom relief and improved sleep quality in patients with RE irrespective of age group, RE severity, and hiatal hernia size.