Efficacy and safety of fexuprazan in patients with symptoms and signs of laryngopharyngeal reflux disease: a randomized clinical trial

Su Il Kim, Young Chan Lee, Wonjae Cha, Ah Ra Jung, Jeon Yeob Jang, Jeong Seok Choi, Dong Kun Lee, Hwan Ho Lee, Min Su Kwon, Yoon Se Lee, Young Gyu Eun

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Purpose: Laryngopharyngeal reflux disease (LPRD) is mainly treated with proton pump inhibitors (PPI) such as esomeprazole, which have shortcomings like delayed absorption and increased osteoporosis. Fexuprazan is a novel potent potassium-competitive acid blocker that inhibits gastric acid secretion with rapid onset and long duration of action. To assess the efficacy and safety of fexuprazan compared to esomeprazole in patients with LPRD. Methods: This prospective, randomized, double-blinded, multicenter, active-controlled trial was conducted in nine otolaryngologic clinics. Patients with reflux symptom index (RSI) ≥ 13 and reflux finding score (RFS) ≥ 7 were randomly assigned to the fexuprazan or esomeprazole groups, and received fexuprazan 40-mg or esomeprazole 40-mg once daily for 8 weeks. The outcomes were (1) mean change, change rate, and valid rate in RSI, RFS, and LPR-related questionnaires; and (2) adverse events. Results: A total of 136 patients (fexuprazan n = 68, esomeprazole n = 68) were followed up for ≥ 1 month. Each parameter significantly improved after 4 and 8 weeks in each group, with no significant differences between the two groups. For those with severe symptoms (RSI ≥ 18), the fexuprazan group (n = 32) showed more improvement in the mean change and change rate in the RSI than esomeprazole group (n = 31) after 4 weeks (p =.036 and.045, respectively). This phenomenon was especially observed in hoarseness and troublesome cough. Conclusion: Fexuprazan improved symptoms and signs without no serious adverse events in patients with LPRD. In patients with severe symptoms, fexuprazan resulted in a faster symptom improvement than PPI. Trial registration: KCT0007251, https://cris.nih.go.kr/cris/search/detailSearch.do?seq=22100.

Original languageEnglish
Pages (from-to)5873-5883
Number of pages11
JournalEuropean Archives of Oto-Rhino-Laryngology
Volume281
Issue number11
DOIs
StatePublished - Nov 2024
Externally publishedYes

Bibliographical note

Publisher Copyright:
© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024.

Keywords

  • Fexuprazan
  • Larynopharyngeal reflux diseases
  • Potassium-competitive acid blocker
  • Proton pump inhibitor
  • Treatment efficacy

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