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Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2021
Katsuhiko Iwakiri1,2, Yasuhiro Fujiwara3, Noriaki Manabe3
1Guidelines Committee for Creating and Evaluating the "Evidence-Based Clinical Practice Guidelines for Gastroesophageal Reflux Disease", The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004, Japan. k-iwa@nms.ac.jp.
Journal of Gastroenterology
|February 28, 2022
Summary
The 2021 Japanese GERD guidelines update treatment algorithms and position vonoprazan (P-CAB) as a key therapy for reflux esophagitis, offering improved clinical strategies for patients.
Area of Science:
- Gastroenterology
- Clinical Practice Guidelines
- Pharmacology
Background:
- Gastroesophageal reflux disease (GERD) prevalence is increasing in Japan.
- Previous guidelines were issued in 2009 and 2015.
- Vonoprazan, a potassium-competitive acid blocker (P-CAB), became available in 2015.
Purpose of the Study:
- To summarize the 3rd edition (2021) of the Japanese Evidence-based Clinical Practice Guidelines for GERD.
- To highlight updates in GERD diagnosis and treatment strategies.
- To clarify the role of vonoprazan in GERD management.
Main Methods:
- Revision of clinical practice guidelines based on new studies and drug availability.
- Development of treatment algorithms classifying GERD into reflux esophagitis and non-erosive reflux disease.
- Integration of vonoprazan into treatment algorithms based on disease severity.
Main Results:
- Updated algorithms classify GERD and guide treatment based on reflux esophagitis severity.
- Vonoprazan is proposed for initial/maintenance treatment of severe reflux esophagitis.
- Vonoprazan or proton pump inhibitors (PPIs) are recommended for mild reflux esophagitis, with vonoprazan suggested for maintenance.
Conclusions:
- The 2021 guidelines provide updated clinical strategies for GERD management in Japan.
- The guidelines incorporate vonoprazan as a significant treatment option.
- These guidelines aim to improve GERD diagnosis and treatment globally.
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