COMPARISON OF DEXLANSOPRAZOLE WITH VONOPRAZAN FOR THE TREATMENT OF ACID PEPTIC DISEASE

Abstract

Irritable Acid peptic disorders involve distinctive, but overlapping pathogenesis that results in gastric hypersecretion, or lessened mucosal defense mechanism. Its associated chronic diseases are most reported in daily clinical practice and produces substantial health burden. For this, proton-pump inhibitors (PPIs) are potent inhibition of acid secretion. However, many drugs in class of PPIs reduce, but do not completely eliminate vulnerability for ulcers and thus representing its reduced potential of targeting physiopathologic pathways and control to maintain intragastric pH ( > 4). Moreover, the decrease speed and duration of action of these drugs have required new therapeutic candidate. Among all, dexlansoprazole is the most effective proton pump inhibitor in this class. Potassium-competitive acid blockers (P-CABs) are novel drugs that inhibit acid production and produce beneficial response. Vonoprazan is recently approved P-CAB for the treatment of gastric hypersecretion disorders. The increase stability in acidic environment, quick absorption, action in both acidic and neutral conditions, long-term stability may address the best option to control acid-peptic diseases. Therefore, the aim of the study was to evaluate and compare the efficacy and safety of dexlanoprazole (Proton pump inhibitors) versus vonoprazan (potassium-competative acid blocker) in the treatment of acid peptic disease. The present study was conducted at National Medical Center, Karachi, Pakistan. A total of 100 acid peptic disease male and female patients will be recruited between the age of 18 to 60 years and fulfilling the inclusion criteria of study. Each patient will give written informed consent and experience 72-hours of wash-out period. All patients will be randomized into 2 groups: group A: dexlansoprazole monotherapy (proton pump inhibitor 60 mg OD) group B: vonoprazan monotherapy (potassium-competitive acid blocker 20 mg OD) for 4 weeks. All the parameters will be identified at 0, 2 and 4th week. At week 0, the statistical analysis shown insignificant results in both groups. Followed by 2 and 4th week of the treatment, significant difference was observed. Group II, i.e. patients treated with vonoprazan were shown least signs as compared to group I patients, i.e dexlansoprazole. Similarly, endoscopy was performed at week 0 and at week 4, significant xi i difference was observed. Both treatment option produce positive effect in the treatment of acid peptic disease. But reports of endoscopy in patients treated with vonoprazon were more effective than other group. The safety profile of both tretments were also identified. At week 4, mean cholesterol in group A was 154.68 and in group B was 154.32, Mean triglyceride in group A was 141.11 and in group B was 152.89, Mean HDL in group A was 145.18 and in group B was 154.82. Mean LDL in group A was 153.24 and in group B and was 144.76 mg/dl. At week 4, mean AST in group A was 134.92 IU/L and in group B was 160.08 IU/L. Mean ALT in group A was 142.06 IU/L and in group B was 155.94 IU/L. Mean alkaline phosphatase in group A was 139.68 IU/L and in group B was 155.32 IU/L. Mean total bilirubin in group A was 152 and in group B and was 144. At week 4, mean creatinine in group A was 152.39 and in group B was 151.94 IU/L. Mean Uric acid in group A was 152.50 and in group B was 153.50. Mean calcium in group A was 151.93 and in group B was 151.07, Mean phosphorus in group A was 146.24 and in group B was 152.76 IU/L. In conclusion, vonoprazan has been found to be more effective than dexlansoprazole alone in treating acid peptic disease. Both vonoprazan and dexlansoprazole has better outcome in acid peptic disease in terms of safety profile