Clinical and Experimental Gastroenterology (Apr 2020)
Vonoprazan Fumarate for the Treatment of Gastric Ulcers: A Short Review on Emerging Data
Abstract
Elisa Marabotto, 1 Sebastiano Ziola, 1 Vincenzo Savarino, 1 Edoardo Giovanni Giannini, 1 Manuele Furnari, 1 Giorgia Bodini, 1 Fabiana Zingone, 2 Matteo Ghisa, 2 Brigida Barberio, 2 Patrizia Zentilin, 1 Edoardo Savarino 2 1Division of Gastroenterology, Department of Internal Medicine, University of Genoa, Genoa, Italy; 2Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, ItalyCorrespondence: Elisa MarabottoDivision of Gastroenterology, Department of Internal Medicine, University of Genoa, Viale Benedetto XV, 6, Genova 16132, ItalyTel/Fax +390103538923Email [email protected]: Potassium-competitive acid blockers (P-CABs), such as vonoprazan, represent a novel and heterogeneous class of drugs that competitively block the potassium binding site of gastric H+/K+ ATPase, thus potentially overcoming the limitations of proton-pump inhibitors. Different studies evaluated the efficacy of vonoprazan versus proton-pump inhibitors (PPIs) for the treatment of acid-related disorders, and, therefore, P-CABs present the same indications of PPIs: gastroesophageal reflux disease, gastric and duodenal ulcer healing, management of upper gastrointestinal bleeding, non-steroidal anti-inflammatory drug (NSAID)-associated ulcers and Helicobacter pylori eradication therapy. The aim of this review was to evaluate the role of vonoprazan for the treatment of peptic ulcer disease (PUD) and the management of gastric ulcer occurring after endoscopic submucosal dissection (ESD). Indeed, vonoprazan (at the dose of both 10 and 20mg) showed similar results to PPIs in patients taking long-term NSAIDs, in the absence of severe adverse effects, and provided a more rapid and effective treatment of ulcers induced by ESD. However, studies in medical literature are heterogeneous, mainly performed with a retrospective design, and often carried out in Japan only. For these reasons, further prospective, randomized studies are warranted in order to help physicians, patients, and policymakers regarding the use of vonoprazan in clinical practice.Keywords: gastric ulcer, P-CAB, adverse events, peptic disease, PPI, H2-receptor antagonists
