Wong Natalie, Reddy Alexander, Patel Amit
Division of Gastroenterology, Duke University School of Medicine, Durham, Nor th Carolina.
Division of Gastroenterology, Duke University School of Medicine and the Durham Veterans Af fairs Medical Center, Durham, Nor th Carolina.
Gastroenterol Hepatol (N Y). 2022 Dec;18(12):693-700.
Potassium-competitive acid blockers (PCABs) such as vonoprazan represent a novel class of acid suppressants that show tremendous promise to enhance care of acid peptic disorders. PCAB characteristics distinct from those of proton pump inhibitors-such as acid stability with dosing independent of food consumption, rapid onset of action, less variability with CYP2C19 polymorphisms, and extended half-lives-may add value in clinical practice. With recently reported data beyond Asian populations and expanding regulatory approval of PCABs, clinicians should be aware of these medications and their potential roles in the management of acid peptic disorders. This article provides an up-to-date summary of the evidence around PCABs for the treatment of gastroesophageal reflux disease (especially erosive esophagitis healing and maintenance), eosinophilic esophagitis, infection, and peptic ulcer healing and secondary prophylaxis.
钾离子竞争性酸阻滞剂(PCABs),如沃克,是一类新型的抑酸剂,在改善酸相关性疾病的治疗方面展现出巨大前景。PCABs具有与质子泵抑制剂不同的特性,例如酸稳定性、给药不受食物摄入影响、起效迅速、CYP2C19基因多态性导致的个体差异较小以及半衰期延长等,这些特性可能在临床实践中具有重要价值。随着近期亚洲人群以外的数据报道以及PCABs监管批准范围的扩大,临床医生应了解这些药物及其在酸相关性疾病管理中的潜在作用。本文提供了关于PCABs治疗胃食管反流病(尤其是糜烂性食管炎的愈合和维持)、嗜酸性食管炎、感染以及消化性溃疡愈合和二级预防的最新证据总结。