A New(-ish) Antacid Medication

The new PCAB Voquenza (vonoprazan) is being marketed as a superior alternative to PPI therapy for acid-related conditions (GERD with or without erosive esophagitis, H. pylori eradication). Are these two mechanisms of action really that different? Jody investigates.

References:

1) Prescriber information: https://www.phathompharma.com/wp-content/uploads/VOQUEZNA-tablets-Prescriber-Information.pdf

2) György Miklós Buzás, Dual acid-pump blocking as novel therapeutic approach to treatment of acid-related diseases, Medical Hypotheses, Volume 187, 2024, 111338, ISSN 0306-9877, https://doi.org/10.1016/j.mehy.2024.111338.

3) Katzka DA, Kahrilas PJ. Potassium-Competitive Acid Blocker Suppression of Gastric Acid in Erosive Esophagitis: Is Stronger and Longer Better? Gastroenterology. 2023 Jan;164(1):14-15. doi: 10.1053/j.gastro.2022.10.022. Epub 2022 Oct 28. PMID: 36341738.

4) Shin JM, Sachs G. Pharmacology of proton pump inhibitors. Curr Gastroenterol Rep. 2008 Dec;10(6):528-34. doi: 10.1007/s11894-008-0098-4. PMID: 19006606; PMCID: PMC2855237.

5) Simadibrata DM, Syam AF, Lee YY. A comparison of efficacy and safety of potassium-competitive acid blocker and proton pump inhibitor in gastric acid-related diseases: A systematic review and meta-analysis. J Gastroenterol Hepatol. 2022 Dec;37(12):2217-2228. doi: 10.1111/jgh.16017. Epub 2022 Oct 26. PMID: 36181401; PMCID: PMC10092067.

6) Oshima T, Miwa H. Potent Potassium-competitive Acid Blockers: A New Era for the Treatment of Acid-related Diseases. J Neurogastroenterol Motil. 2018 Jul 30;24(3):334-344. doi: 10.5056/jnm18029. PMID: 29739175; PMCID: PMC6034668