The efficacy and safety of fexuprazan in treating erosive esophagitis: a phase III, randomized, double-blind, multicenter study

• Published in: Journal of gastroenterology and hepatology Vol. 39; no. 4; pp. 658 - 666
• Main Authors: Zhuang, Qianjun, Liao, Aijun, He, Qingling, Liu, Chengxia, Zheng, Changqing, Li, Xing, Liu, Youli, Wang, Bangmao, Liu, Side, Zhang, Yan, Lin, Rong, Chen, Huixin, Deng, Min, Tang, Yanping, He, Chiyi, Dai, Weijie, Tang, Haitao, Gong, Lei, Li, Liangping, Xu, Baohong, Yang, Changqing, Zhou, Bingxi, Su, Dongxing, Guo, Qinghong, Li, Bin, Zhou, Yongjian, Wang, Xiaoyang, Fei, Sujuan, Wu, Huili, Wei, Sichen, Peng, Zhihong, Wang, Jianning, Li, Yanqing, Wang, Hong, Deng, Tianwei, Ding, Shigang, Li, Fangfang, Chen, Minhu, Xiao, Yinglian
• Format: Journal Article
• Language: English
• Published: Australia Wiley Subscription Services, Inc 01.04.2024
• Subjects: Esophagitis; Omeprazole
• ISSN: 0815-9319; 1440-1746; 1440-1746
• DOI: 10.1111/jgh.16471

Fexuprazan is a novel potassium-competitive acid blocker (P-CAB). This study aimed to explore the noninferior efficacy and safety of fexuprazan to esomeprazole in treating erosive esophagitis (EE). This was a phase III, randomized, double-blind multicenter study. Patients with endoscopically confirmed EE were randomized to receive fexuprazan 40 mg or esomeprazole 40 mg once a daily for 4-8 weeks. The healing rates of EE, symptom response, GERD-health-related quality life (GERD-HRQL), and treatment-emergent adverse events (TEAEs) were compared between fexuprazan group and esomeprazole group. A total of 332 subjects were included in full analysis set (FAS) and 311 in per-protocol set (PPS). The healing rates of fexuprazan and esomeprazole groups at 8 weeks were 88.5% (146/165) and 89.0% (145/163), respectively, in FAS and 97.3% (145/149) and 97.9% (143/146), respectively, in PPS. Noninferiority of fexuprazan compared with esomeprazole according to EE healing rates at 8 weeks was demonstrated in both FAS and PPS analysis. No significant difference was found between groups in EE healing rates at 4 weeks, symptom responses, and changes of GERD-HRQL. The incidence of drug-related AEs was 19.4% (32/165) in fexuprazan arm and 19.6% (32/163) in esomeprazole arm. This study demonstrated noninferior efficacy of fexuprazan to esomeprazole in treating EE. The incidence of TEAEs was similar between fexuprazan and esomeprazole. Trial registration number NCT05813561.