Potassium-competitive acid blockers.

IF 2.5 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Current Opinion in Gastroenterology Pub Date : 2025-11-01 Epub Date: 2025-07-23 DOI:10.1097/MOG.0000000000001127
Trevor A Davis, C Prakash Gyawali
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引用次数: 0

Abstract

Purpose of review: Acid suppression is the mainstay of management of common foregut disorders, including gastroesophageal reflux disease (GERD), peptic ulcer disease and Helicobacter pylori infection. Drawbacks of standard management with proton pump inhibitors (PPIs) include acid lability requiring enteric coating, slow onset of effect, lack of suppression of nocturnal acid breakthrough, and need for administration before meals.

Recent findings: Potassium-competitive acid blockers (PCABs) are a novel class of acid suppressants that are effective in the management of symptomatic and erosive GERD, peptic ulcer disease and H. pylori infection. Administration before meals is not needed, and these agents achieve profound acid suppression right from the first dose, with control of daytime as well as nocturnal acid. In randomized controlled trials, PCABs are noninferior and often superior to PPIs, especially in healing of advanced grade esophagitis and eradication of treatment-naive as well as refractory H. pylori. The safety profile of PCABs over 10 years of use is reassuring, although profound acid suppression may contribute to hypergastrinemia and increased risk of gastrointestinal infections.

Summary: As PCABs become available in many countries around the globe, real-world use will allow further research to determine the clinical niche of these acid-suppressive agents.

钾竞争性酸阻滞剂。
综述目的:抑酸是治疗常见前肠疾病的主要方法,包括胃食管反流病(GERD)、消化性溃疡病和幽门螺杆菌感染。质子泵抑制剂(PPIs)标准管理的缺点包括酸不稳定,需要肠内包衣,起效慢,缺乏抑制夜间酸突破,需要饭前给药。最近发现:钾竞争酸阻滞剂(PCABs)是一类新型抑酸剂,可有效治疗症状性和糜烂性胃食管反流、消化性溃疡疾病和幽门螺杆菌感染。不需要饭前给药,这些药物从第一次剂量起就能实现深刻的抑酸作用,控制白天和夜间的酸。在随机对照试验中,PCABs并不亚于PPIs,而且往往优于PPIs,特别是在晚期食管炎的愈合和治疗初期以及难治性幽门螺杆菌的根除方面。尽管深度抑酸可能导致高胃泌素血症和胃肠道感染风险增加,但使用10年以上的pcab的安全性令人放心。摘要:随着pcab在全球许多国家的使用,现实世界的使用将允许进一步的研究来确定这些酸抑制剂的临床利基。
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来源期刊
Current Opinion in Gastroenterology
Current Opinion in Gastroenterology 医学-胃肠肝病学
CiteScore
5.30
自引率
0.00%
发文量
137
审稿时长
6-12 weeks
期刊介绍: ​​​​​​​Published bimonthly and offering a unique and wide ranging perspective on the key developments in the field, each issue of Current Opinion in Gastroenterology features hand-picked review articles from our team of expert editors. With twelve disciplines published across the year – including gastrointestinal infections, nutrition and inflammatory bowel disease – every issue also contains annotated references detailing the merits of the most important papers.
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