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.