Vonaprazan Versus Esomeprazole for Healing of LA Grade B or Higher Esophagitis After POEM

Peroral Endoscopic Myotomy (POEM) is a well-established treatment for achalasia; however, it is frequently associated with gastroesophageal reflux disease (GERD), with many patients developing LA grade B or higher esophagitis. Proton pump inhibitors (PPIs) like Esomeprazole are the standard treatment, but Vonaprazan, a potassium-competitive acid blocker (P-CAB), offers superior acid suppression and may provide enhanced healing in post-POEM reflux esophagitis. Primary Objective: • To compare the healing rates of LA grade B or higher reflux esophagitis at 8 weeks in patients receiving Vonaprazan 20 mg versus Esomeprazole 40 mg. Secondary Objectives * To assess improvement in reflux symptoms using the GERD-Q score at 8 weeks. * To evaluate the incidence of adverse events in each treatment group.

NCT Number	NCT06955520
Lead Sponsor	Asian Institute of Gastroenterology, India
Conditions	GERD
Enrollment	300 participants
Start Date	2025-04-30
Primary Completion	2027-12-10 (estimated)
Study Completion	2028-12-25 (estimated)
Updated on ClinicalTrials.gov	2026-04-27