The Novel Drug for Acid Related Diseases
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Abstract
Acid suppression treatments have revolutionized the management of the acid-related disorders since the introduction of the H2-receptor antagonists (H2-RAs) and the proton pump inhibitors (PPIs). However, a number of limitations including slow onset of action, influence by cytochrome P450 polymorphisms, unsatisfactory side effects at night, and instability in acidic conditions has been noted. The major advance in the treatment of the acid-related disorders has been the development of Potassium-Competitive Acid Blockers (P-CABs), the potassium channel acid blocking drugs which block the K+,H+-ATPase K+ channel. P-CABs are food independent, reversible, have a rapid onset of action, and maintain a prolonged and consistent elevation of intragastric pH. Vonoprazan was recently innovated as a novel, orally active P-CAB. This drug does not require enteric coating as it is acid-stable, and it can be taken without food. Vonoprazan accumulates in parietal cells under both acidic and neutral conditions. It does not require an acidic environment for activation, has long-term stability at the site of action, and has satisfactory safety and tolerability. Thus, vonoprazan may address the unmet medical need for the treatment of the acid-related diseases.
To review and summarized the published literatures to date concerning different aspects of potassium channel acid blocking P-CAB including mechanism of action, indication of treatment and long-term safety.
Conclusion: vonoprazan is superior to conventional PPIs for suppressing acid secretion, especially at night, and there was no difference in efficacy depending on CYP2C19 genotype status. In addition, vonoprazan was shown to overcome the weaknesses associated with conventional PPIs. Thus, vonoprazan may address the unmet medical need for the treatment of acid-related diseases.
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References
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