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Short-Term Daily Vonoprazan Treatment Is More Commonly Associated With Infectious Gastroenteritis Than Short-Term
Zaid Al-Fakhouri1, Benjamin Douglas Xun Liu2, Laith AlOmari3
1Department of Medicine, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio, USA.
Neurogastroenterology and Motility
|June 8, 2026
Summary
Vonoprazan use was linked to a higher risk of infectious gastroenteritis within 90 days compared to proton pump inhibitors (PPIs). This finding is crucial for understanding the short-term safety profiles of these acid-reducing medications.
Area of Science:
- Gastroenterology
- Pharmacology
- Clinical Medicine
Background:
- Proton pump inhibitors (PPIs) are associated with known adverse effects.
- Vonoprazan, a novel potassium-competitive acid blocker, is now available in the US.
- Short-term side effect profiles of vonoprazan and PPIs require comparison.
Purpose of the Study:
- To compare the short-term adverse effects of vonoprazan versus PPIs.
- To evaluate the incidence of specific complications within 90 days of initiating therapy.
- To assess safety differences in a global patient cohort.
Main Methods:
- A global cohort of new vonoprazan or PPI users was identified using TriNetX.
- Patients were matched for demographics, comorbidities, and medication history.
- Kaplan-Meier and Cox proportional hazards models were used to assess risks within 90 days.
Main Results:
- 11,851 patients were propensity score matched between the vonoprazan and PPI groups.
- Vonoprazan users showed a higher risk of infectious gastroenteritis (HR 2.06) globally and in GERD patients (HR 3.00).
- No significant differences were found in risks for pneumonia, iron deficiency, or B12 deficiency.
Conclusions:
- Vonoprazan use is associated with an increased risk of infectious gastroenteritis within 90 days compared to PPIs.
- The study highlights a specific short-term safety concern for vonoprazan.
- Further research may be needed to explore long-term effects and mechanisms.
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