A Comprehensive Review on Novel Potassium Competitive Acid Blocker Vonoprazan in the Treatment of Gastrointestinal Disorders

Abstract

Vonoprazan, a first-in-class potassium-competitive acid blocker (P-CAB), represents a significant advancement in the management of acid-related disorders. This novel agent demonstrates rapid, potent, and sustained acid suppression through its unique mechanism of reversibly binding to the gastric H+/K+-ATPase proton pump. Vonoprazan maintains stable inhibition of acid secretion regardless of CYP2C19 polymorphisms, offering advantages over traditional proton pump inhibitors (PPIs). Clinical studies have established its superior efficacy in treating various acid-related conditions, including gastroesophageal reflux disease (GERD), peptic ulcer disease, and Helicobacter pylori infection. The drug exhibits remarkable healing rates in erosive esophagitis and maintains long-term remission effectively. In H. pylori eradication therapy, vonoprazan-based regimens have shown higher success rates compared to conventional PPI-based treatments, particularly in areas with high antibiotic resistance. The pharmacokinetic profile of vonoprazan allows for flexible dosing schedules and rapid onset of action, enhancing patient compliance. Safety analyses from long-term studies indicate a favorable tolerability profile, with most adverse events being mild to moderate in severity. The emergence of vonoprazan has expanded therapeutic options for acid-related disorders, particularly benefiting patients who show inadequate response to conventional PPI therapy. Recent data also suggest potential applications in prevention of low-dose aspirin-induced ulcers and management of non-erosive reflux disease (NERD).