Does the Novel Potassium-Competitive Acid Blocker Vonoprazan Cause More Hypergastrinemia than Conventional Proton Pump Inhibitors? A Multicenter Prospective Cross-Sectional Study
Does the Novel Potassium-Competitive Acid Blocker Vonoprazan Cause More Hypergastrinemia than Conventional Proton Pump Inhibitors? A Multicenter Prospective Cross-Sectional Study
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DOI：
10.1159/000484217
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发表时间：
2018-01-01
期刊：
影响因子：
3.2
通讯作者：
Higuchi, Kazuhide
中科院分区：
文献类型：
--
作者：
Kojima, Yuichi;Takeuchi, Toshihisa;Higuchi, Kazuhide
背景/目的：长期使用质子泵抑制剂（PPI）可有效预防复发性反流性食管炎。另一方面，已报告了几种不良反应，如血液胃泌素水平升高。本研究的目的是检查与沃诺拉赞相比，常规PPI长期给药导致的血液胃泌素水平升高。方法：采用前瞻性横断面研究。我们检查了服用沃诺拉赞或常规PPI的患者的血液胃泌素水平，这些患者在过去一年中通过内镜评价了萎缩性胃炎的等级。结果如下：在轻度或无萎缩性胃炎患者中，沃诺拉赞组的血胃泌素水平显著高于PPI组，与给药期无关。但在重度萎缩性胃炎患者中，两组间无显著差异。结论：在轻度或无萎缩性胃炎患者中，与常规PPI相比，沃诺拉赞更显著地增加了血胃泌素水平。这表明沃诺拉赞在此类患者中的抑酸作用可能比传统PPI更强。关键信息：我们应了解沃诺拉赞长期给药期间高胃泌素血症的潜在发展，尤其是在轻度或无萎缩性胃炎的患者中。(c)2018 S. Karger AG，巴塞尔
Background/Aim: The long-term administration of proton pump inhibitors (PPIs) is useful for preventing recurrent reflux esophagitis. On the other hand, several adverse reactions, such as an increase in the blood gastrin level, have been reported. The aim of the present study was to examine the increase in the blood gastrin level due to the long-term administration of conventional PPIs compared with vonoprazan. Methods: A prospective cross-sectional study was conducted. We examined the blood gastrin levels of patients taking vonoprazan or conventional PPIs in whom the grade of atrophic gastritis had been endoscopically evaluated in the last year. Results: The blood gastrin level was significantly higher in the vonoprazan group than that in the PPI group in patients with milder or no atrophic gastritis, irrespective of the administration periods. However, no significant difference was observed between the groups in patients with severe atrophic gastritis. Conclusion: Vonoprazan more markedly increased the blood gastrin level compared with conventional PPIs in patients with milder or no atrophic gastritis. This indicates that vonoprazan may have stronger acid-suppressing effects in such patients than conventional PPIs. Key Message: We should be aware of the potential development of hypergastrinemia during the long-term administration of vonoprazan, especially in patients with mild or no atrophic gastritis. (c) 2018 S. Karger AG, Basel