Potassium-competitive acid blockers (P-CABs) constitute a relatively new class of gastric acid-suppressing drugs. Among this class, vonoprazan is the first to have been approved in the United States. However, some P-CABs including vonoprazan, tegoprazan and fexuprazan have been available in other countries since at least 2014. The first aim of this article is to review pharmacological differences between P-CABs that are currently approved or in development with proton pump inhibitors (PPIs). The specific focus thereafter is on the likely role of P-CABs in the treatment of different manifestations of gastroesophageal reflux disease (GERD). Multiple clinical trials have compared P-CABs with PPIs in erosive esophagitis. Additional trials have compared P-CABs with placebo in non-erosive reflux disease. Relevant results are reviewed and inferences drawn for their use in the US. Lastly, consideration is given to additional, potential uses of P-CABs in the broader spectrum of GERD and some suggestions made for future research initiatives.

中文翻译：

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P-CABs 在 GERD 中的作用。


钾竞争性酸阻滞剂 （P-CAB） 是一类相对较新的胃酸抑制药物。在这类药物中，沃诺拉赞是第一个在美国获得批准的药物。然而，至少自 2014 年以来，一些 P-CAB（包括沃诺拉赞、替戈拉赞和非舒普拉赞）已在其他国家/地区上市。本文的第一个目的是回顾目前已批准或正在开发的质子泵抑制剂 （PPI） 的 P-CABs 之间的药理学差异。此后的具体重点是 P-CABs 在治疗胃食管反流病 （GERD） 不同表现中的可能作用。多项临床试验比较了 P-CABs 与 PPI 治疗糜烂性食管炎。其他试验将 P-CABs 与安慰剂在非糜烂性反流病中的疗效进行了比较。审查了相关结果并得出了在美国使用它们的推论。最后，考虑了 P-CABs 在更广泛的 GERD 中的其他潜在用途，并对未来的研究计划提出了一些建议。