Yuichi Kojima1,2, Toshihisa Takeuchi1,2, Makoto Sanomura3, Ken Higashino4, Keishi Kojima5, Kenji Fukumoto6, Kou Takata7, Hiroki Sakamoto8, Masahiro Sakaguchi9, Kazunari Tominaga10, Kazuhide Higuchi2. 1. Endoscopy Center, Osaka Medical College, Osaka, Japan. 2. Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan. 3. Department of Gastroenterology, Hokusetsu General Hospital, Osaka, Japan. 4. Department of Gastroenterology, Shiroyama Hospital, Osaka, Japan. 5. Department of Internal Medicine, Sousei Hospital, Osaka, Japan. 6. Department of Internal Medicine, Taishou Hospital, Osaka, Japan. 7. Department of Gastroenterology, Shitennouji Hospital, Osaka, Japan. 8. Department of Gastroenterology, Katsuragi Hospital, Osaka, Japan. 9. Department of Gastroenterology, Moriguchi Keijinkai Hospital, Osaka, Japan. 10. Premier Developmental Research of Medicine, Osaka Medical College, Osaka, Japan.
Abstract
BACKGROUND/AIM: The long-term administration of proton pump inhibitors (PPIs) is useful for preventing recurrent reflux esophagitis. On the other hand, several adverse reactions, such as an increase in the blood gastrin level, have been reported. The aim of the present study was to examine the increase in the blood gastrin level due to the long-term administration of conventional PPIs compared with vonoprazan. METHODS: A prospective cross-sectional study was conducted. We examined the blood gastrin levels of patients taking vonoprazan or conventional PPIs in whom the grade of atrophic gastritis had been endoscopically evaluated in the last year. RESULTS: The blood gastrin level was significantly higher in the vonoprazan group than that in the PPI group in patients with milder or no atrophic gastritis, irrespective of the administration periods. However, no significant difference was observed between the groups in patients with severe atrophic gastritis. CONCLUSION: Vonoprazan more markedly increased the blood gastrin level compared with conventional PPIs in patients with milder or no atrophic gastritis. This indicates that vonoprazan may have stronger acid-suppressing effects in such patients than conventional PPIs. Key Message: We should be aware of the potential development of hypergastrinemia during the long-term administration of vonoprazan, especially in patients with mild or no atrophic gastritis.
BACKGROUND/AIM: The long-term administration of proton pump inhibitors (PPIs) is useful for preventing recurrent reflux esophagitis. On the other hand, several adverse reactions, such as an increase in the blood gastrin level, have been reported. The aim of the present study was to examine the increase in the blood gastrin level due to the long-term administration of conventional PPIs compared with vonoprazan. METHODS: A prospective cross-sectional study was conducted. We examined the blood gastrin levels of patients taking vonoprazan or conventional PPIs in whom the grade of atrophic gastritis had been endoscopically evaluated in the last year. RESULTS: The blood gastrin level was significantly higher in the vonoprazan group than that in the PPI group in patients with milder or no atrophic gastritis, irrespective of the administration periods. However, no significant difference was observed between the groups in patients with severe atrophic gastritis. CONCLUSION:Vonoprazan more markedly increased the blood gastrin level compared with conventional PPIs in patients with milder or no atrophic gastritis. This indicates that vonoprazan may have stronger acid-suppressing effects in such patients than conventional PPIs. Key Message: We should be aware of the potential development of hypergastrinemia during the long-term administration of vonoprazan, especially in patients with mild or no atrophic gastritis.