The management of acid-based disorders was transformed in the 1980s with the advent of proton pump inhibitors (PPIs), which target the hydrogen-potassium adenosine triphosphatase (proton pump) of the parietal cell. Potassium-competitive acid blockers (P-CABs), a newer class of medications, act at the same proton pump through a novel mechanism resulting in profound and sustained acid suppression. Although trials in Asian populations over the past decades have highlighted the potential benefit of P-CABs, clinical trials in Western populations have been initiated more recently. These trials evaluated vonoprazan in patients with Helicobacter pylori infection, erosive esophagitis, and heartburn with nonerosive reflux disease and have demonstrated promising results, culminating in US Food and Drug Administration approval for these indications. Adverse event profiles between PPIs and P-CABs appear comparable thus far, although additional long-term data on P-CABs are needed. While navigating the evolving landscape of acid suppression, it is crucial to identify which patients and diseases are poised to derive the most benefit from this emerging therapeutic option. This article seeks to highlight important pharmacologic properties of PPIs and P-CABs, understand the current literature with a focus on clinical trials in Western populations, and explore potential scenarios for integrating P-CABs into therapeutic regimens.
{"title":"Potassium-Competitive Acid Blockers and Proton Pump Inhibitors: The Dynamic Duo of Acid Blockers.","authors":"Corey J Ketchem, Kristle L Lynch","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The management of acid-based disorders was transformed in the 1980s with the advent of proton pump inhibitors (PPIs), which target the hydrogen-potassium adenosine triphosphatase (proton pump) of the parietal cell. Potassium-competitive acid blockers (P-CABs), a newer class of medications, act at the same proton pump through a novel mechanism resulting in profound and sustained acid suppression. Although trials in Asian populations over the past decades have highlighted the potential benefit of P-CABs, clinical trials in Western populations have been initiated more recently. These trials evaluated vonoprazan in patients with <i>Helicobacter pylori</i> infection, erosive esophagitis, and heartburn with nonerosive reflux disease and have demonstrated promising results, culminating in US Food and Drug Administration approval for these indications. Adverse event profiles between PPIs and P-CABs appear comparable thus far, although additional long-term data on P-CABs are needed. While navigating the evolving landscape of acid suppression, it is crucial to identify which patients and diseases are poised to derive the most benefit from this emerging therapeutic option. This article seeks to highlight important pharmacologic properties of PPIs and P-CABs, understand the current literature with a focus on clinical trials in Western populations, and explore potential scenarios for integrating P-CABs into therapeutic regimens.</p>","PeriodicalId":52498,"journal":{"name":"Gastroenterology and Hepatology","volume":"20 12","pages":"733-738"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Safety of Long-Term Ozanimod Treatment Up to 5 Years in Patients With Moderately to Severely Active Ulcerative Colitis: An Interim Analysis of the True North Open-Label Extension.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":52498,"journal":{"name":"Gastroenterology and Hepatology","volume":"20 12 Suppl 10","pages":"14-15"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Aerobic Exercise Training Leads to MASH Resolution as Defined by the MASH Resolution Index Without Body Weight Loss.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":52498,"journal":{"name":"Gastroenterology and Hepatology","volume":"20 12 Suppl 11","pages":"17-18"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Efficacy and Safety of Guselkumab Maintenance Therapy Among Guselkumab Induction Week 24 Clinical Responders: Results From the Phase 3 QUASAR Maintenance Study.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":52498,"journal":{"name":"Gastroenterology and Hepatology","volume":"20 12 Suppl 10","pages":"2-3"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Plecanatide Is Efficacious in Patients With Irritable Bowel Syndrome With Constipation and Bloating: Evaluation Using Trisymptom Composite Endpoints.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":52498,"journal":{"name":"Gastroenterology and Hepatology","volume":"20 12 Suppl 9","pages":"12-13"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Highlights From the Recent World Health Organization Guidelines for Hepatitis B Virus Infection.","authors":"Douglas T Dieterich","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":52498,"journal":{"name":"Gastroenterology and Hepatology","volume":"20 12","pages":"742-744"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Elafibranor Long-Term Efficacy and Safety and Impact on Fatigue in Primary Biliary Cholangitis: Interim Results From the Open-Label Extension of the ELATIVE Trial Up to 3 Years.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":52498,"journal":{"name":"Gastroenterology and Hepatology","volume":"20 12 Suppl 12","pages":"3-4"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Results From the 52-Week Phase 2b VOYAGE Trial of VK2809 in Patients With Biopsy-Confirmed Non-Alcoholic Steatohepatitis and Fibrosis: A Randomized, Placebo-Controlled Trial.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":52498,"journal":{"name":"Gastroenterology and Hepatology","volume":"20 12 Suppl 11","pages":"13-14"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Efficacy of Risankizumab Maintenance Therapy by Clinical Remission and Endoscopic Improvement Status in Patients With Moderately to Severely Active Ulcerative Colitis: Post Hoc Analysis of the COMMAND Phase 3 Study.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":52498,"journal":{"name":"Gastroenterology and Hepatology","volume":"20 12 Suppl 10","pages":"8-9"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Assessment of Resmetirom Efficacy (80 mg vs. 100 mg) Stratified by Baseline Body Mass Index and Weight in Patients From the MAESTRO-NASH Trial.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":52498,"journal":{"name":"Gastroenterology and Hepatology","volume":"20 12 Suppl 11","pages":"12-13"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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