Comparación de Vonoprazan y Esomeprazol en el tratamiento de la Esofagitis Erosiva por Enfermedad de Reflujo Gastroesofágico
Resumen
La esofagitis erosiva (EE) se trata habitualmente con inhibidores de la bomba de protones (IBPs), aunque una proporción de pacientes no alcanza una curación completa. Los bloqueadores ácido-competitivos de potasio (P-CABs) ofrecen una inhibición más potente y sostenida del ácido gástrico. Objetivo: El objetivo del presente estudio fue comparar directamente la probabilidad de curación con Vonoprazan y Esomeprazol en el tratamiento de la esofagitis erosiva asociada a enfermedad por reflujo gastroesofágico, evaluando tanto la resolución de los síntomas como la curación endoscópica. Metodología: Estudio observacional prospectivo con 60 pacientes entre 18 y 75 años, divididos en dos grupos de 30. Un grupo recibió Vonoprazan 20 mg dos veces al día (BID) y el otro Esomeprazol 20 mg BID durante 8 semanas. Se realizaron endoscopias al inicio y al final, y se registró diariamente la presencia de pirosis y regurgitación. Resultados: Vonoprazan mostró mayores tasas de curación endoscópica en todos los grados de severidad (A–D). En el Grado D logró un 50% de curación, mientras Esomeprazol no resolvió ningún caso. Alivio sintomático: Vonoprazan logró desaparición total de síntomas desde el día 2 hasta la semana 8 en todos los pacientes, mientras que con Esomeprazol persistieron síntomas leves en algunos casos. No se observaron efectos adversos relevantes. Conclusión: Vonoprazan es superior a Esomeprazol en curación endoscópica y control sintomático rápido en el tratamiento de la EE.
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DOI: http://dx.doi.org/10.61155/gen.v80i1.794
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| Figura 1. Tumor Neuroendocrino Gástrico | Figura 2. Hiperplasia de Células Neuroendocrinas en estómago |
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ISSN: 0016-3503 e-ISSN: 2477-975X