Gastroesophageal reflux-induced chronic cough (GERC) refers to the clinical complex of reflux of stomach acid and other stomach contents, resulting in chronic cough as the only or main symptom. GERC is a special type of gastroesophageal reflux disease (GERD)1 and a common cause of chronic cough.2 Proton-pump inhibitors (PPIs) are the standard treatment for GERC. PPIs have a slow onset and long duration of action, so they should be taken 30 min or 1 h before meals.3 Moreover, more than 36 % of GERC patients have a poor response to PPIs after 8 weeks of standard treatment and require intensive antacid therapy, such as doubling the dose of PPIs.4 Conventional antacid therapy in approximately one-third of patients with GERC is not effective which is referred to as refractory GERC.5 Previous research results from our department suggested that baclofen and other neuroregulators are potential treatment options for refractory GERC, but the efficacy is not satisfactory, with a treatment failure rate of more than 40 % and frequent central nervous system side effects, such as dizziness and lethargy.6 A novel anti-acid drug potassium-channel acid blocker (P-CAB), vonoprazan fumarate tablets, has been recommended for the treatment of GERD according to current guidelines.7 The P-CAB pharmacokinetics and pharmacodynamics were shown to be superior to PPIs in theory. Thus far, studies have confirmed that vonoprazan is significantly superior to PPIs in the treatment of GERD with similar safety.8 Moreover, vonoprazan has the characteristics of quick onset and potent action, which have certain advantages in the treatment of severe GERD.9

Recent studies have shown that P-CAB is effective for GERC.10, 11 However, there are no reports involving P-CAB and refractory GERC treatment at present. Herein, we report three patients with refractory GERC who did not respond well to PPIs but were successfully treated with vonoprazan fumarate tablets, thus, providing a therapeutic basis for the clinical treatment of refractory GERC.