Erosive Esophagitis (EE) - Market Insight, Epidemiology, and Market Forecast - 2034

Key Highlights:

• Esophagitis is the inflammation or damage of the esophageal lining, most often caused by gastroesophageal reflux, which can result in erosive esophagitis.
• Reflux or erosive esophagitis that occurs because of the reflux of gastric contents into the stomach leading to mucosal injury is one of the most common causes of esophagitis.
• Vonoprazan was discovered and developed by Takeda and approved in Japan in 2014 for the treatment of reflux esophagitis. It is marketed as TAKECAB in Japan, where it plays a central role in managing acid-related disorders. Later, Phathom Pharmaceuticals licensed the rights to vonoprazan for the United States, Europe, and commercialized it as VOQUEZNA, the first potassium-competitive acid blocker approved in the United States.
• Sebela Pharmaceuticals is developing Tegoprazan, a fast-acting potassium-competitive acid blocker (P-CAB), for erosive esophagitis in the US. Cinclus Pharma is advancing Linaprazan glurate, a Phase III P-CAB candidate targeting moderate to severe erosive gastroesophageal reflux disease (GERD) in Europe and the US, addressing a large unmet medical need.
• Market growth in Erosive Esophagitis is driven by rising GERD prevalence, greater awareness, and the limitations of standard PPI therapy, such as refractory symptoms and relapse. Demand is further fueled by next-generation acid-suppressive drugs, novel drug delivery systems, and a growing focus on long-term mucosal healing. Expanding access in emerging markets and active R&D targeting unmet needs continue to support sustained market expansion.

DelveInsight's comprehensive report titled "Erosive Esophagitis- Market Insights, Epidemiology, and Market Forecast - 2034" offers a detailed analysis of Erosive Esophagitis. The report presents historical and projected epidemiological data covering total prevalent cases of Erosive Esophagitis, total diagnosed prevalent cases of Erosive Esophagitis, gender-specific cases of Erosive Esophagitis, age-specific cases of Erosive Esophagitis, and treated cases of Erosive Esophagitis. In addition to epidemiology, the market report encompasses various aspects related to the patient population. These aspects include the diagnosis process, prescription patterns, physician perspectives, market accessibility, treatment options, and prospective developments in the market across seven major markets: the United States, EU4 (Germany, France, Italy, and Spain), the United Kingdom, and Japan, spanning from 2020 to 2034.

The report analyzes the existing treatment practices and unmet medical requirements in Erosive Esophagitis. It evaluates the market potential and identifies potential business prospects for enhancing therapies or interventions. This valuable information enables stakeholders to make well-informed decisions regarding product development and strategic planning for the market.

Erosive Esophagitis Overview

Erosive esophagitis is the most common complication of gastroesophageal reflux disease, caused by excessive acid reflux that damages the esophageal lining. This leads to inflammation, erosions, ulcerations, and in severe cases, bleeding. It is important to distinguish erosive esophagitis from nonerosive reflux disease, where no visible damage to the esophageal mucosa is observed.

Patients with erosive esophagitis often report symptoms such as heartburn and regurgitation, but more severe cases may include difficulty swallowing and painful swallowing. While most individuals respond well to treatment, a significant subset-up to 15 percent-continues to experience persistent symptoms despite receiving proton pump inhibitor therapy for eight weeks. These cases are considered treatment-resistant, highlighting the need for more effective and targeted therapeutic approaches.

Erosive Esophagitis Diagnosis and Treatment Algorithm

Esophagogastroduodenoscopy (EGD) is the primary diagnostic tool for confirming erosive esophagitis, especially in patients with refractory symptoms, alarm features, or those being evaluated for antireflux surgery. Unlike barium esophagram, which has limited utility, EGD allows direct visualization of mucosal damage, biopsy sampling, and therapeutic interventions for complications such as hemorrhage or strictures.

For patients with refractory disease or atypical symptoms, additional tests may be used to assess acid and non-acid reflux or esophageal motility. These include 24-hour impedance-pH monitoring, the 96-hour Bravo pH test, and high-resolution manometry. While not needed for most patients, these tests help evaluate persistent symptoms, detect weak acid or bile reflux, and guide treatment decisions, particularly before surgical intervention.

The main goals of treating erosive esophagitis are to relieve symptoms, heal the esophageal lining, prevent complications, and maintain long-term control of the disease. While lifestyle modifications can support treatment, most patients require acid-suppressive medications such as H2 blockers, proton pump inhibitors (PPIs), or P-CABs. PPIs are generally very effective, but some patients may continue to experience symptoms. In such cases, treatment can be optimized by adjusting the timing or dosage, switching to a different PPI, or adding a nighttime H2 blocker to improve symptom control.

For patients unresponsive to PPIs, P-CABs such as vonoprazan offer a newer treatment option with rapid and potent acid suppression, fewer rebound effects, and effective control of symptoms. Agents like motility drugs and sucralfate have limited roles and are reserved for specific cases, such as pregnancy or gastroparesis. Long-term maintenance therapy is often necessary, especially in severe cases, and is considered safe when properly monitored and tailored to individual patient needs.

Erosive Esophagitis Epidemiology

The epidemiology section of the erosive esophagitis market report offers information on the patient populations, including historical and projected trends for each of the seven major markets. Examining key opinion leader views from physicians or clinical experts can assist in identifying the reasons behind historical and projected trends. The diagnosed patient pool, their trends, and the underlying assumptions are all included in this section of the report.

This section also presents the data with relevant tables and graphs, offering a clear and concise view of the prevalence of Erosive Esophagitis. Additionally, the report discloses the assumptions made during the analysis, ensuring data interpretation and presentation transparency. This epidemiological data is valuable for understanding the disease burden and its impact on the patient population across various regions.

Key Findings

As per secondary sources, around 30% of individuals with GERD may develop erosive esophagitis.

Global data on the prevalence of erosive esophagitis are limited, experts estimate that it affects roughly 1% of the general population.

The epidemiology of Erosive Esophagitis is expected to change during the forecast period (2025-2034).

Erosive Esophagitis Market Outlook

The Erosive Esophagitis therapeutics market is further expected to increase by the major drivers, such as the rising prevalence population, technological advancements, and upcoming therapies in the forecast period (2025-2034).

With ongoing research and continued dedication, the future holds hope for even more effective treatments and, ultimately, a cure for this challenging condition. According to DelveInsight, the Erosive Esophagitis market in the 7MM is expected to change significantly during the forecast period 2025-2034.

Erosive Esophagitis Drug Chapters

Marketed Erosive Esophagitis Drugs

VOQUEZNA/TAKECAB: Phathom Pharmaceuticals/Takeda Pharmaceuticals

VOQUEZNA (vonoprazan) is an oral small-molecule P-CAB, representing a new class of medications that inhibit stomach acid production. It is the first P-CAB approved in the United States. Vonoprazan has demonstrated the ability to deliver strong acid suppression, reaching pH levels that may enhance treatment outcomes.

Phathom Pharmaceuticals holds the rights to vonoprazan in the US, Europe, and Canada through a licensing agreement with Takeda, which markets the drug across Japan, Asia, and parts of Latin America.

TAKECAB, discovered by Takeda, is a novel treatment for acid-related diseases that works by competitively blocking potassium ions from binding to H+, K+-ATPase, and the final step in gastric acid secretion.

Takeda and Otsuka entered a co-promotion agreement in March 2014, with Takeda responsible for manufacturing and marketing TAKECAB in Japan.

In November 2023, Phathom Pharmaceuticals announced that the US FDA has approved VOQUEZNA (vonoprazan) tablets in 10 mg and 20 mg strengths. This novel P-CAB is now authorized for use in adults for healing all grades of erosive esophagitis (also known as erosive GERD), maintaining healing, and providing relief from heartburn linked to the condition.

In December 2014, Takeda Pharmaceutical Company and Otsuka Pharmaceutical Company announced that Japan's Ministry of Health, Labour and Welfare has granted approval for the New Drug Application submitted by Takeda for TAKECAB (vonoprazan fumarate), a medication developed for the treatment of acid-related disorders (reflux esophagitis).

Emerging Erosive Esophagitis Drugs

The Erosive Esophagitis market is expected to evolve gradually, driven by the limited number of emerging therapies currently in development. Key players such as Tegoprazan by Sebela Pharmaceuticals and Linaprazan glurate by Cinclus Pharma among others are showing active commitment to addressing this unmet need, with ongoing efforts to advance novel treatment options for this complex condition.

Tegoprazan: Sebela Pharmaceuticals

Tegoprazan (BLI5100) is a novel agent in development for the treatment of acid-related gastrointestinal diseases. It is a member of a class of oral medications known as P-CABs, or potassium-competitive acid blockers, which have been shown to have rapid onset of action and the ability to control gastric pH for longer periods of time than proton pump inhibitors (PPIs).

Tegoprazan is a novel agent in development for the US market by Braintree, a part of Sebela Pharmaceuticals for the treatment of acid-related gastrointestinal diseases. Tegoprazan has already received approvals in multiple territories, including South Korea and China.

Phase III studies are underway to evaluate the safety and efficacy of Tegoprazan in patients with erosive esophagitis.

In April 2025, Sebela Pharmaceuticals announced positive topline results from its Phase III TRIUMpH program evaluating tegoprazan for GERD, showing that the drug acts faster and is more effective than proton pump inhibitors in treating erosive esophagitis. Tegoprazan met all primary and secondary endpoints in the healing phase of erosive esophagitis.

Linaprazan glurate: Cinclus Pharma

Linaprazan glurate, a prodrug of linaprazan initially developed by AstraZeneca, is a P-CAB that has shown superior acid control in studies. It targets a significant unmet need in over 20 million patients with moderate to severe erosive GERD across Europe and the USA.

Linaprazan glurate is being evaluated in the Phase III clinical trial.

In May 2025, Cinclus Pharma announced that the company presented positive data at the scientific conference Digestive Disease Week in San Diego. The presentations included data on linaprazan glurate's good capacity to inhibit acid production as well as positive data on the optimized tablet formulation developed for the Phase III studies and an upcoming commercialization.

Erosive Esophagitis Market Segmentation

DelveInsight's 'Erosive Esophagitis- Market Insights, Epidemiology, and Market Forecast - 2034' report provides a detailed outlook of the current and future erosive esophagitis market, segmented within countries, by therapies, and by classes. Further, the market of each region is then segmented by each therapy to provide a detailed view of the current and future market share of all therapies.

Erosive Esophagitis Market Size by Countries

The erosive esophagitis market size is assessed separately for various countries, including the United States, EU4 (Germany, France, Italy, and Spain), the UK, and Japan. In 2024, the United States held a significant share of the overall 7MM (Seven Major Markets) erosive esophagitis market, primarily attributed to the country's higher prevalence of the condition and the elevated cost of the available treatments. This dominance is projected to persist, especially with the potential early introduction of new products.

Erosive Esophagitis Drugs Uptake

This section focuses on the sales uptake of potential erosive esophagitis drugs that have recently been launched or are anticipated to be launched in the Erosive Esophagitis market between 2020 and 2034. It estimates the market penetration of Erosive Esophagitis drugs for a given country, examining their impact within and across classes and segments. It also touches upon the financial and regulatory decisions contributing to the probability of success (PoS) of the drugs in the Erosive Esophagitis market.

The emerging erosive esophagitis therapies are analyzed based on various attributes such as safety and efficacy in randomized clinical trials, order of entry and other market dynamics, and the unmet need they fulfill in the erosive esophagitis market.

Erosive Esophagitis Market Access and Reimbursement

DelveInsight's 'Erosive Esophagitis- Market Insights, Epidemiology, and Market Forecast - 2034' report provides a descriptive overview of the market access and reimbursement scenario of erosive esophagitis.

This section includes a detailed analysis of the country-wise healthcare system for each therapy, enlightening the market access, reimbursement policies, and health technology assessments.

KOL Views

To keep up with current erosive esophagitis market trends and fill gaps in secondary findings, we interview KOLs and SMEs' working in the Erosive Esophagitis domain. Their opinion helps understand and validate current and emerging therapies and treatment patterns or erosive esophagitis market trends. This will support the clients in potential upcoming novel treatments by identifying the overall scenario of the market and the erosive esophagitis unmet needs.

Erosive Esophagitis: KOL Insights

DelveInsight's analysts connected with 50+ KOLs to gather insights; however, interviews were conducted with 15+ KOLs in the 7MM. These KOLs were from organizations, institutes, and hospitals, such as Department of Medicine, Columbia University, US, University Hospital Cologne, Germany, University of Barcelona, Spain, institut arnault tzanck, France, Cambridge University, UK, and Hyogo College of Medicine, Japan, among others.

"The idea that obesity may contribute to the development of erosive esophagitis is supported by biological mechanisms. Obesity is linked to higher intra-abdominal pressure, delayed gastric emptying, reduced lower esophageal sphincter (LES) tone, and more frequent transient LES relaxations-all of which can increase acid exposure in the esophagus."

"Several medications and health conditions can damage the esophageal lining and contribute to the development of erosive esophagitis. These include drugs like nitrates, calcium channel blockers, benzodiazepines, anticholinergics, and antidepressants. Additionally, medical conditions such as obesity, stroke, diabetes, and Parkinson's disease are known to impact esophageal function and are linked to an increased risk of erosive esophagitis."

"Patients with erosive esophagitis often require continued acid suppression with proton pump inhibitors or potassium-competitive acid blockers to prevent relapse and complications. These therapies should be used at the lowest effective dose and for the shortest duration. If treatment with proton pump inhibitors extends beyond six months, gradual tapering is advised before stopping. For mild or occasional symptoms, H2 receptor antagonists may be considered."

Competitive Intelligence Analysis

We conduct a Competitive and Market Intelligence analysis of the erosive esophagitis Market, utilizing various Competitive Intelligence tools such as SWOT analysis and Market entry strategies. The inclusion of these analyses is contingent upon data availability, ensuring a comprehensive and well-informed assessment of the market landscape and competitive dynamics.

Erosive Esophagitis Pipeline Development Activities

The report offers an analysis of therapeutic candidates in Phase II and III stages and examines companies involved in developing targeted therapeutics for erosive esophagitis. It provides valuable insights into the advancements and progress of potential treatments in clinical development for this condition.

Pipeline Development Activities

The report covers information on collaborations, acquisition and merger, licensing, patent details, and other information for emerging Erosive Esophagitis therapies.

Erosive Esophagitis Report Insights

• Erosive Esophagitis Patient Population
• Therapeutic Approaches
• Erosive Esophagitis Pipeline Analysis
• Erosive Esophagitis Market Size and Trends
• Erosive Esophagitis Market Opportunities
• Impact of Upcoming Therapies

Erosive Esophagitis Report Key Strengths

• 10 Years Forecast
• The 7MM Coverage
• Erosive Esophagitis Epidemiology Segmentation
• Key Cross Competition
• Highly Analyzed Erosive Esophagitis Market
• Erosive Esophagitis Drugs Uptake

Erosive Esophagitis Report Assessment

• Erosive Esophagitis Current Treatment Practices
• Unmet Needs
• Erosive Esophagitis Pipeline Product Profiles
• Erosive Esophagitis Market Attractiveness

Key Questions:

• How common is Erosive Esophagitis?
• What are the key findings of Erosive Esophagitis epidemiology across the 7MM, and which country will have the highest number of patients during the study period (2020-2034)?
• What are the currently available treatments for Erosive Esophagitis?
• What are the disease risk, burden, and unmet needs of Erosive Esophagitis?
• At what CAGR is the Erosive Esophagitis market and its epidemiology is expected to grow in the 7MM during the forecast period (2025-2034)?
• How would the unmet needs impact the Erosive Esophagitis market dynamics and subsequently influence the analysis of the related trends?
• What would be the forecasted patient pool of Erosive Esophagitis in the 7MM covering the United States, EU4 (Germany, France, Italy, and Spain), the UK, and Japan?
• Among EU4 and the UK, which country will have the highest number of patients during the forecast period (2025-2034)?
• How many companies are currently developing therapies for the treatment of Erosive Esophagitis?

Reasons to buy:

• The report will help in developing business strategies by understanding the latest trends and changing treatment dynamics driving the Erosive Esophagitis Market.
• Insights on patient burden/disease prevalence, evolution in diagnosis, and factors contributing to the change in the epidemiology of the disease during the forecast years.
• To understand the existing market opportunity in varying geographies and the growth potential over the coming years.
• Distribution of historical and current patient share based on real-world prescription data along with reported sales of current treatment in the US, EU4 (Germany, France, Italy, and Spain), the United Kingdom, and Japan.
• Identification of strong upcoming players in the market will help in devising strategies that will help in getting ahead of competitors.
• Detailed analysis and ranking of class-wise potential current and emerging therapies under the conjoint analysis section to provide visibility around leading classes.
• Highlights of Access and Reimbursement policies of approved therapies, barriers to accessibility of off-label expensive therapies, and patient assistance programs.
• To understand the perspective of Key Opinion Leaders around the accessibility, acceptability, and compliance-related challenges of existing treatment to overcome barriers in the future.
• Detailed insights on the unmet needs of the existing market so that the upcoming players can strengthen their development and launch strategy.

Frequently Asked Questions:

1. What are the treatment goals for Erosive Esophagitis?

The main goals in managing erosive esophagitis are to relieve symptoms, promote healing of the esophageal lining, and prevent complications such as strictures or bleeding. Treatment focuses on reducing acid exposure to the esophagus, thereby minimizing inflammation and discomfort like heartburn and regurgitation. Long-term management aims to maintain remission, improve quality of life, and reduce the risk of relapse while minimizing reliance on long-term high-dose medication or surgical intervention.

2. What are the challenges in managing Erosive Esophagitis?

Managing erosive esophagitis is challenging due to its multifactorial causes, overlapping gastrointestinal symptoms, and frequent recurrence. Individualized treatment is needed, especially in patients who do not fully respond to proton pump inhibitors. Management is further complicated by comorbidities like obesity or diabetes, limited access to newer therapies such as potassium-competitive acid blockers, and concerns about adherence, cost, and the long-term safety of acid suppression.

3. What are the key factors driving the growth of the Erosive Esophagitis market?

Key factors driving growth in the Erosive Esophagitis market include greater disease awareness, rising prevalence of risk factors like obesity, and increased use of advanced therapies such as potassium-competitive acid blockers for PPI-resistant cases. Improved diagnostics, better treatment adherence, and broader healthcare access in emerging markets further support market expansion.

4. How will the Erosive Esophagitis Market and Epidemiology Forecast Report benefit the clients?

The report will provide comprehensive insights into the current Erosive Esophagitis market landscape, emerging therapies, competitive dynamics, regulatory requirements, and market access considerations, enabling informed decision-making, strategic planning, and optimization of business strategies to capitalize on market opportunities and drive growth.