Vonoprazan Endorsed for Refractory GERD in India

Summary: India’s first expert consensus now backs vonoprazan for treating refractory GERD (rGERD), a condition affecting nearly 40% of GERD patients who don’t respond to PPIs. This new guidance is a big step forward in improving patient outcomes, quality of life, and treatment precision.

Struggling with Acid Reflux That Won’t Quit? India Has a New Answer

If you’ve been taking proton pump inhibitors (PPIs) for acid reflux but your symptoms just won’t go away, you’re not alone. Around 40% of GERD patients continue to suffer despite standard PPI treatment, a condition known as refractory GERD (rGERD).

Here’s the good news: A new expert consensus from India, the first of its kind, has officially endorsed vonoprazan, a novel acid suppressant, for treating rGERD. Published in the March 2025 issue of the Journal of the Association of Physicians of India, this consensus marks a major milestone in GERD management for Indian patients.

What Is Refractory GERD (rGERD)?

Refractory GERD occurs when symptoms of gastroesophageal reflux persist despite at least eight weeks of PPI therapy. In these cases, the acid reflux is confirmed to be ongoing, affecting both the

Patient’s health
Quality of life

Why Is rGERD a Big Deal?

Nearly 4 in 10 patients don’t respond well to PPIs.

Ongoing symptoms can affect daily productivity.
It increases healthcare costs due to additional tests and medications.

Also Read: Antibiotics Once? Your Gut May Stay Resistant for Years

Meet Vonoprazan: A Breakthrough in GERD Treatment

Vonoprazan is a potassium-competitive acid blocker (P-CAB). Unlike PPIs, which irreversibly block acid pumps, vonoprazan reversibly inhibits the proton pump, offering:

Faster relief
More consistent acid suppression
Stronger overall control

Global studies have already shown how effective it is, and now it’s India’s turn.

India’s First rGERD Consensus: What the Experts Say

To fill the gap in Indian-specific data, a panel of 35 top Indian gastroenterologists reviewed global literature and clinical experiences. After two structured meetings, they created 14 consensus statements to guide rGERD treatment in India, with a clear focus on vonoprazan.

The statements were supported by levels of evidence (LOE) and voted on using a five-point Likert scale to reach agreement (LOA).

Recommendations from the Indian Consensus

Always reassess symptoms, lifestyle, and medication compliance before modifying treatment.
Partial response to PPIs can hurt quality of life and increase treatment costs.
Post-endoscopy rGERD patients may need further tests like manometry and 24-hour pH impedance.
Therapeutic lifestyle changes play a crucial role in improving rGERD.
P-CABs like vonoprazan are as effective as PPIs for initial GERD treatment.
Vonoprazan is preferred for on-demand or intermittent long-term management of rGERD.
It outperforms PPIs in healing and maintaining severe reflux disease (Los Angeles Grade C or D).
Recommended dose: Vonoprazan 20 mg once daily for 4–8 weeks for initial treatment.

Why is this important for Indian Patients

This consensus offers much-needed clarity for Indian clinicians treating patients who haven’t responded to PPIs. The panel’s endorsement of vonoprazan reflects a shift toward precision and evidence-based care in GERD management.

As quoted in the paper,

“Vonoprazan may be an alternative for PPI-rGERD based on its pharmacokinetic and pharmacodynamic profile.”

Final Takeaway: A New Era for GERD Care in India

The expert panel’s conclusion is clear, vonoprazan works better for many patients with rGERD. Its powerful acid suppression and faster action make it a valuable tool in the fight against persistent reflux.

This Indian consensus is a step forward in tailoring GERD treatment to real-world clinical needs, ensuring better outcomes and an improved quality of life for millions.

If you’re still struggling with acid reflux despite PPIs, it might be time to talk to your doctor about vonoprazan.

I am an MBBS graduate and a dedicated medical writer with a strong passion for deep research and psychology. I enjoy breaking down complex medical topics into engaging, easy-to-understand content, aiming to educate and inspire readers by exploring the fascinating connection between health, science, and the human mind.