Potassium-competitive acid blockers: rethinking acid suppression for gastroesophageal reflux disease and Helicobacter pylori

被引:3
作者
Antequera, Carol M. [1 ]
Orleck, Kimberly [2 ]
Jacob, Rinu [3 ]
Kenneally, Amy [3 ]
Wright, Wendy L. [4 ,5 ]
机构
[1] Univ Miami, Div Gastroenterol, Miami, FL USA
[2] Atlanta Gastroenterol Associates, Atlanta, GA USA
[3] Phathom Pharmaceut, Florham Pk, NJ USA
[4] Wright & Associates Family Healthcare PLLC, Amherst, NH USA
[5] Wright & Associates Family Healthcare PLLC, 282 State Route 101 Units 9 & 10, Amherst, NH 03031 USA
关键词
Gastroesophageal reflux disease; Helicobacter pylori; proton pump inhibitors; potassium competitive acid blockers; clinical trials; patient management; therapy; FRESH-FROZEN PLASMA; INTERNATIONAL NORMALIZED RATIO; CLINICAL-PRACTICE GUIDELINE; TRAUMA-INDUCED COAGULOPATHY; CRITICALLY-ILL PATIENTS; LIVER-DISEASE; INVASIVE PROCEDURES; CIRRHOTIC-PATIENTS; SURGICAL-PATIENTS; OPEN-LABEL;
D O I
10.1080/00325481.2024.2320081
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Gastroesophageal reflux disease (GERD) and Helicobacter pylori (H. pylori) infection are different disease states that are united by the core role of acid suppression in their management. In GERD, proton pump inhibitors (PPIs) have long been standard therapy based on abundant positive clinical trial data supporting their efficacy and safety. In H. pylori, PPIs are also a critical element of therapy in combination with 1 or more antibiotics to achieve and maintain a pH that maximizes the efficacy of therapy. Despite the considerable clinical success and widespread use of PPIs, room remains for agents with differentiated pharmacokinetic and pharmacodynamic profiles. The potassium-competitive acid blockers (PCABs) are mechanistically distinct from PPIs but are acid-stable and do not require activation of the proton pump by coadministration of food. In pharmacodynamic studies, these agents have shown greater durations of acid suppression above the critical threshold of pH 4 (for GERD) and pH 6 (for H. pylori), which have been shown to optimize therapeutic efficacy in these settings. These results have translated in clinical studies to similar and, in some cases, improved outcomes relative to PPIs in these disease states. This review summarizes current knowledge on the physiology of acid secretion, pathophysiology and management of GERD and H. pylori, and key characteristics and clinical trial data for PPIs and PCABs.
引用
收藏
页码:131 / 140
页数:10
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