Gastroesophageal reflux disease (GERD) affects millions of Americans and is typically managed using over-the-counter and prescription medications. However, there have been limited advancements in GERD pharmaceutical management in the past few decades. Proton pump inhibitors (PPIs) emerged as a game-changer in the late 1980s and early 1990s, but they still have limitations.
Potassium-competitive acid blockers (PCABs), such as vonoprazan, are being considered as potential treatments for erosive GERD. The U.S. Food and Drug Administration (FDA) is set to review vonoprazan in mid-November. Unlike PPIs, PCABs work on both active and inactive stomach pumps, allowing for more flexible timing of medication intake. They are also quicker to act and have been used safely in several Asian countries for a few years.
PCABs have already been approved for the treatment of H. pylori in the U.S., providing some safety data. Recent clinical data has shown that vonoprazan is noninferior to available PPIs and may even be superior in more severe cases of GERD. The safety and effectiveness of PCABs, including vonoprazan, are still being studied, particularly in American patients who have different diets and lifestyles compared to Asian patients.
In addition to treating GERD, PCABs may also be assessed for treating peptic strictures and preventing progression to cancer in patients with Barrett’s esophagus. Further research is needed to determine the optimal dosage and whether PCABs can be taken on an as-needed basis.
Overall, these advancements in GERD treatment offer hope for improved management of this common digestive condition. With further research and development, PCABs like vonoprazan could potentially provide more effective and tailored treatment options for patients with GERD.
– Chamil Codipilly, MD, gastroenterologist with the Mayo Clinic (interview with HCPLive)
– FDA (U.S. Food and Drug Administration) (source of potential drug review information)