Vonoprazan fumarate, a novel potassium-competitive acid blocker, in the management of gastroesophageal reflux disease: safety and clinical evidence to date.
Vonoprazan fumarate, a novel potassium-competitive acid blocker, in the management of gastroesophageal reflux disease: safety and clinical evidence to date.
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Vonoprazan Fumarate是一种新型的钾肥酸阻滞剂，用于胃食管反流疾病的管理：迄今为止的安全性和临床证据。
DOI：
10.1177/1756283x17745776
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发表时间：
2018
影响因子：
4.2
通讯作者：
Sugano K
中科院分区：
文献类型：
--
作者：
Sugano K
钾竞争性酸阻滞剂（P-CAB）是一类竞争性阻断H+， K+-三磷酸腺苷（ATP）酶的钾结合位点的药物。尽管这类药物的历史始于30多年前，但两种p - cab（雷帕赞和伏诺哌赞）的临床应用直到最近才分别在韩国和日本获得批准。其中，vonoprazan与传统质子泵抑制剂（PPIs）相比具有几个优势，包括起效快、抑酸持续时间长、抑酸方面的个体间差异较小、饮食对其作用的影响最小。vonoprazan的这些优点已经在一些酸相关疾病的许可批准的临床试验中得到证实。在这篇综述文章中，将总结伏诺哌赞在胃食管反流病（GERD）治疗中的现有证据。由于临床试验数据以及上市后的临床数据一致表明，vonoprazan在实现粘膜破裂愈合和维持愈合方面优于传统ppi，因此它可能为满足当前胃反流治疗的一些未满足的需求提供了极好的选择。伏诺哌嗪的安全性问题也进行了讨论，因为更明显的高胃泌素血症不可避免地随之而来的使用。
Potassium-competitive acid blocker (P-CAB) is a class of drug that competitively blocks the potassium-binding site of H+, K+-adenosine triphosphate (ATP)ase. Although the history of this class of drugs started over 30 years ago, clinical use of two P-CABs, revaprazan and vonoprazan, were only recently approved in Korea and Japan, respectively. Among them, vonoprazan has several advantages over conventional proton-pump inhibitors (PPIs), including rapid onset of action, long duration of acid suppression, fewer interindividual variations in terms of acid suppression, and minimum dietary influence on its action. These advantages of vonoprazan have been proved in clinical trials conducted for license approvals for several acid-related diseases. In this review article, current evidence of vonoprazan in the management of gastroesophageal reflux disease (GERD) will be summarized. Since the clinical trial data, as well as postmarketed clinical data, have consistently demonstrated superiority of vonoprazan over conventional PPIs in terms of achieving healing of mucosal breaks and maintaining the healing, it may provide an excellent, if not complete, option for fulfilling some of the unmet needs for current GERD therapy. The safety problem of vonoprazan is also discussed, as more pronounced hypergastrinemia inevitably ensues with its use.