An update of pharmacology, efficacy and safety of vonoprazan in acid-related disorders

Expert Rev Gastroenterol Hepatol. 2021 Sep 22. doi: 10.1080/17474124.2021.1984878. Online ahead of print.ABSTRACTINTRODUCTION: Patients with acid-related disorders (ARDs) of the upper digestive tract remain highly prevalent and need to be continuously investigated to improve their management.AREAS COVERED: This review provides a summary of the most recent advancements in the treatment of ARDs with particular focus on the new drugs available to overcome the unmet needs of traditional therapies.EXPERT OPINION: Proton pump inhibitors remain the best therapy in treating ARDs, but a consistent proportion of these patients continues to present mucosal lesions or to experience symptoms despite treatment. These cases pertain mainly to the most severe forms of erosive esophagitis or to non-erosive reflux disease. Also, the increasing rate of patients with H. pylori infection not responding to eradication therapy represents a difficult clinical condition. The recent advent of a new class of antisecretory drugs, such as the potassium competitive acid blockers and, among them the most studied vonoprazan, which are characterized by a better pharmacological profile than PPIs (rapid onset of action, longer-lasting acid suppression, control of nocturnal acidity) has the potential to overcome the above-mentioned unmet needs. More research should be done to assess their efficacy in western populations and their safety in patients treated in the long term.PMID:34550866 | DOI:10.1080/17474124.20...
Source: Expert Review of Gastroenterology and Hepatology - Category: Gastroenterology Authors: Source Type: research

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CONCLUSIONS: The rate of development of symptomatic GERD after successful H. pylori eradication is low over long-term follow-up and is easily controlled by vonoprazan therapy. However, patients with smoking habits, functional dyspepsia, hiatal hernia, or severe gastric atrophy should be followed carefully after eradication.PMID:34547219 | DOI:10.1080/00365521.2021.1975310
Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Authors: Source Type: research
Abstract Proton pump inhibitors (PPIs) are widely used for acid suppression in the treatment and prevention of many conditions including gastroesophageal reflux disease, gastric and duodenal ulcers, erosive esophagitis, H. pylori infection, and pathological hypersecretory conditions. Most PPIs are metabolized primarily by CYP2C19 into inactive metabolites, and CYP2C19 genotype has been linked to PPI exposure, efficacy, and adverse effects. We summarize the evidence from the literature and provide therapeutic recommendations for PPI prescribing based on CYP2C19 genotype (updates at www.cpicpgx.org). The potential b...
Source: Clinical Pharmacology and Therapeutics - Category: Drugs & Pharmacology Authors: Tags: Clin Pharmacol Ther Source Type: research
AbstractThe Indian Society of Gastroenterology developed this evidence-based practice guideline for management of gastroesophageal reflux disease (GERD) in adults. A modified Delphi process was used to develop this consensus containing 58 statements, which were generated by electronic voting iteration as well as face-to-face meeting and review of the supporting literature primarily from India. These statements include 10 on epidemiology, 8 on clinical presentation, 10 on investigations, 23 on treatment (including medical, endoscopic, and surgical modalities), and 7 on complications of GERD. When the proportion of those who...
Source: Indian Journal of Gastroenterology - Category: Gastroenterology Source Type: research
In conclusion, vonoprazan 10 mg daily is effective in improving GERD symptoms. Advanced age, obesity, erosive esophagitis, alcohol use and history of H. pylori eradication influence the resolution of GERD symptoms. Treatment with vonoprazan favorably affects gastrointestinal symptoms in patients with GERD.
Source: The Kaohsiung Journal of Medical Sciences - Category: Universities & Medical Training Source Type: research
Esophageal adenocarcinoma (EAC) is rapidly increasing in incidence in many Western societies, requires demanding treatment, and is associated with a poor prognosis, therefore preventive measures are highly warranted. To assess the opportunities for prevention, we reviewed the available literature and identified seven main potentially preventive targets. Preventive effects were found on the basis of medium-level observational evidence following treatment of gastroesophageal reflux disease (using both medication and surgery) and tobacco smoking cessation, which should be clinically recommended among exposed patients. Nonster...
Source: Cancer Prevention Research - Category: Cancer & Oncology Authors: Tags: Review Source Type: research
Esophageal adenocarcinoma (EAC) is rapidly increasing in incidence in many Western societies, requires demanding treatment, and is associated with a poor prognosis, therefore preventive measures are highly warranted. To assess the opportunities for prevention, we reviewed the available literature and identified seven main potentially preventive targets. Preventive effects were found on the basis of medium-level observational evidence following treatment of gastroesophageal reflux disease (using both medication and surgery) and tobacco smoking cessation, which should be clinically recommended among exposed patients. Nonster...
Source: Cancer Prevention Research - Category: Cancer & Oncology Authors: Tags: Review Source Type: research
Abstract Peptic ulcer disease (PUD) has been further decreased over the last decades along with decreasing prevalence of Helicobacter pylori‐associated PUD. A delayed H. pylori eradication has been associated with an increased risk of rehospitalization for complicated recurrent peptic ulcer and reemphasized the importance of eradication especially in patients with peptic ulcer bleeding (PUB). PUB associated with NSAID/aspirin intake and H. pylori revealed an additive interaction in gastric pathophysiology which favors the “test‐and‐treat” strategy for H. pylori in patients with specific ris...
Source: Helicobacter - Category: Gastroenterology Authors: Tags: Original Article Source Type: research
Conclusion Night-shift work is suggested to be a risk factor for erosive esophagitis. Avoidance of night-shift work and lifestyle modification should be considered for prevention and management of gastroesophageal reflux disease.
Source: International Archives of Occupational and Environmental Health - Category: Occupational Health Source Type: research
Background: The prevalence of gastroesophageal reflux disease (GERD) has increased in Japan since the end of the 20th century due to changes in environmental factors, such as a decreased infection rate of Helicobacter pylori and increased ability of acid secretion in the Japanese population. In 2013, the Japanese health insurance system started to cover eradication treatment for all patients infected with H. pylori to prevent gastric cancer, suggesting we may soon be able to completely eradicate this infection in Japan. Re-clarification of the clinical characteristics of GERD in Japan is therefore required in time covering...
Source: Digestion - Category: Gastroenterology Source Type: research
Proton pump inhibitors (PPIs) are a class of acid suppression medications that block gastric parietal cell acid production by irreversibly inhibiting the luminal H+/K+ adenylpyrophosphatase (ATPase).1 PPIs are used for a variety of conditions involving inflammation of the upper gastrointestinal tract in children, including gastroesophageal reflux disease, erosive esophagitis, gastric and duodenal ulcers, eosinophilic esophagitis, and Helicobacter pylori gastritis.2-4 Alternative uses for PPIs are increasing, and include treatment of various pediatric respiratory symptoms, sleep disorders, and even irritability or excessive crying in infants.
Source: The Journal of Pediatrics - Category: Pediatrics Authors: Tags: Medical Progress Source Type: research
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