Vonoprazan fumarate for the management of acid-related diseases

ABSTRACT

Introduction: Proton pump inhibitors (PPIs) display a number of limitations and unmet clinical needs that have prompted the development of novel drugs to improve the outcomes of acid-related diseases, including the eradication of H. pylori. In this context, a new synthesized potassium-competitive acid blocker (P-CAB), vonoprazan, showed higher suppression of gastric acid secretion.

Areas covered: This review discusses the current knowledge regarding the efficacy of vonoprazan in the treatment of acid-related diseases, with a particular focus on its use in Helicobacter pylori eradication.

Expert opinion: Vonoprazan showed some advantages over PPIs in terms of the pharmacokinetic and pharmacodynamic profile: fast onset of action without requiring acid activation and specific administration timing, more potent and prolonged inhibition of acid secretion, including a better nighttime acid control, and a less antisecretory variability. Recent evidence suggests that vonoprazan can be preferred to PPIs as maintenance therapy for reflux esophagitis and eradication of Helicobacter pylori owing to its stronger antisecretory effect. Moreover, vonoprazan displays favorable safety and tolerability profiles, even though long-term studies on the effects of vonoprazan are required.

KEYWORDS:

• Vonoprazan
• gastro-esophageal reflux disease
• GERD
• pharmacokinetics
• P-CABs

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This paper was not funded.

Notes on contributors

Irene Martinucci

Irene Martinucci, Corrado Blandizzi and Edoardo Savarino have contributed to the design of the study, data collection, writing of the manuscript, and approval of the final manuscript.

Giorgia Bodini

Giorgia Bodini, Elisa Marabotto, Vincenzo Savarino, Santino Marchi, Nicola de Bortoli have contributed to the design of the study, data collection and approval of the final manuscript.