The potential role of potassium-competitive acid blockers in the treatment of gastroesophageal reflux disease

Purpose of review Gastroesophageal reflux disease (GERD) is primarily a motor disorder, but its pathogenesis is multifactorial. Although gastric acid secretion is usually normal in GERD patients, treatment with proton pump inhibitors (PPIs) has become the standard of care, despite increasing awareness of their shortcomings. In this article, a new class of antisecretory drugs (namely potassium-competitive acid blockers, P-CABs), developed to overcome these limitations, is discussed. Recent findings P-CABs block the K+ exchange channel of the proton pump, resulting in rapid, competitive, reversible inhibition of acid secretion. These drugs offer a more rapid elevation of intragastric pH than PPIs, while maintaining similar antisecretory effect, the duration of which is dependent on half-life and can be prolonged with extended release formulations. Thus, P-CABs offer advances in the treatment of GERD including rapid heartburn relief, faster and more reliable healing of severe grades of erosive esophagitis, as a consequence of better control of nighttime acid secretion than PPIs. Summary P-CABs overcome many of the drawbacks of PPIs. The unique antisecretory effects of vonoprazan might be especially useful in the long-term treatment of patients with Barrett's esophagus.
Source: Current Opinion in Gastroenterology - Category: Gastroenterology Tags: ESOPHAGUS: Edited by Stuart J. Spechler Source Type: research

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CONCLUSION Male gender and hiatal hernia were associated with EE. Aged patients, smoking and hiatal herni a were related to severe EE. It is suggested that the risk factors for EE and non-EE types are different. Cohort studies are necessary to identify the exact mechanisms involved in each disease form.RESUMO CONTEXTO: A doen ça do refluxo gastroesofágico (DRGE) é uma das doenças digestivas mais comuns na prática médica e deve ser suspeitada de acordo com os seus sintomas clínicos, podendo ser classificada em esofagite erosiva (EE) de acordo com os achados de endoscopia. OBJ...
Source: Arquivos de Gastroenterologia - Category: Gastroenterology Source Type: research
CONCLUSIONS: These data showed that GERD is present in a quarter of ABG patients, suggesting that hypochlorhydria not exclude per se arising of oesophageal symptoms. In ABG we found that ME is a frequent finding but its clinical relevance remains to be investigated with further studies. PMID: 30638085 [PubMed - as supplied by publisher]
Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research
ConclusionsDexlansoprazole is safe and efficacious for healing EE and maintenance of healed EE in adolescents.
Source: Digestive Diseases and Sciences - Category: Gastroenterology Source Type: research
Abstract AIM: To compare vonoprazan 10 and 20 mg vs lansoprazole 15 mg as maintenance therapy in healed erosive esophagitis (EE). METHODS: A total of 607 patients aged ≥ 20 years, with endoscopically-confirmed healed EE following 8 wk of treatment with vonoprazan 20 mg once daily, were randomized 1:1:1 to receive lansoprazole 15 mg (n = 201), vonoprazan 10 mg (n = 202), or vonoprazan 20 mg (n = 204), once daily. The primary endpoint of the study was the rate of endoscopically-confirmed EE recurrence during a 24-wk maintenance period. The secondary endpoint was the EE recurrence rate at Week 12 during maint...
Source: World Journal of Gastroenterology : WJG - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research
CONCLUSION: The management of this disease requires a complex approach. Maintenance therapy of GERD after using anti-secretory drugs should be continuously monitored. PMID: 29560670 [PubMed - in process]
Source: Acta Gastro-Enterologica Belgica - Category: Gastroenterology Tags: Acta Gastroenterol Belg Source Type: research
Conclusion This randomized double-blind, placebo-controlled clinical trial demonstrated that Amla could reduce frequencies of heartburn and regurgitation and improve heartburn and regurgitation severity in patients with NERD. Trial Registration Iranian Registry of Clinical Trials IRCT2016061428469N1.
Source: Journal of Integrative Medicine - Category: Complementary Medicine Source Type: research
Abstract Gastroesophageal reflux disease (GERD) is a gastrointestinal motility disorder that results from the reflux of stomach contents into the esophagus or oral cavity resulting in symptoms or complications. The typical symptoms of GERD are heartburn and regurgitation of gastric contents into the oropharynx. GERD affects quality of life and may cause erosive esophagitis, esophageal strictures, and Barrett esophagus, a precursor to esophageal adenocarcinoma. GERD is a clinical diagnosis and is most effectively treated with proton-pump inhibitors (PPIs). Long-term use of PPIs is associated with bone fractures, ch...
Source: Primary Care - Category: Primary Care Authors: Tags: Prim Care Source Type: research
Gastroesophageal reflux disease (GERD) is a gastrointestinal motility disorder that results from the reflux of stomach contents into the esophagus or oral cavity resulting in symptoms or complications. The typical symptoms of GERD are heartburn and regurgitation of gastric contents into the oropharynx. GERD affects quality of life and may cause erosive esophagitis, esophageal strictures, and Barrett esophagus, a precursor to esophageal adenocarcinoma. GERD is a clinical diagnosis and is most effectively treated with proton-pump inhibitors (PPIs). Long-term use of PPIs is associated with bone fractures, chronic renal diseas...
Source: Primary Care: Clinics in Office Practice - Category: Primary Care Authors: Source Type: research
Authors: Usai Satta P, Oppia F, Cabras F Abstract Gastro-esophageal reflux disease (GERD) is a very prevalent condition and has a high impact on the quality of life. Nevertheless, pathophysiology is complex and multi-factorial. Several mechanisms have been proposed: decreased salivation, decreased lower esophageal sphincter pressure resting tone, presence of hiatal hernia, increased number of transient lower esophageal sphincter relaxations, increased acid, and pepsin secretion, duodeno-gastro-esophageal reflux of bile acids and trypsin. Other factors contributing to the pathophysiology of GERD include poor esophag...
Source: Minerva Gastroenterologica e Dietologica - Category: Gastroenterology Tags: Minerva Gastroenterol Dietol Source Type: research
Data from a meta-analysis study of Mederi Therapeutics Stretta device released this week indicate that treatments with the device reduced heartburn and improved health-related quality of life scores for patients with gastroesophageal reflux disease. The company’s Stretta catheter system applies low-poet radio frequency energy to remodel the lower esophageal sphincter to restore natural barrier function and reduce spontaneous regurgitation caused by transient relaxations of the sphincter. In the study, researchers analyzed results from 28 studies of the Stretta system, including data from 2,468 unique Stretta patients...
Source: Mass Device - Category: Medical Equipment Authors: Tags: Clinical Trials Otolaryngology Ear, Nose & Throat Mederi Therapeutics Inc. Source Type: news
More News: Acid Reflux | Erosive Esophagitis | Gastroenterology | Gastroesophageal Reflux Disease | GERD | Heartburn | Potassium | Proton Pump Inhibitors PPIs