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Curr Opin Pharmacol. 2008 Dec;8(6):677-84. doi: 10.1016/j.coph.2008.09.004. Epub 2008 Oct 24.

Proton pump inhibitors: the beginning of the end or the end of the beginning?

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  • 1Laboratory of Clinical Pharmacology, Department of Anatomy, Pharmacology & Forensic Sciences, School of Medicine & Dentistry, University of Parma, Parma, Italy.


Despite the dramatic success of pharmacological acid suppression in healing peptic ulcers (PUs) and managing patients with gastro-esophageal reflux disease (GERD) a number of challenges remain in the management of acid-related disorders. Several new drugs are currently being investigated to provide a significant advance over current treatments. These include new drug formulations, novel proton pump inhibitors (PPIs) as well as potassium-competitive acid blockers (P-CABs), which have already reached clinical testing. Some others (like NO-releasing antisecretory compounds) are still in preclinical development and require proof of concept in humans. While H(2)-receptor antagonists (especially soluble or OTC formulations) will become the 'antacids of the third millennium' and will be particularly useful for on-demand symptom relief, clinicians will continue to rely on PPIs to control acid secretion in GERD and other acid-related diseases. Since an increasing proportion of patients fail to respond to the best PPI treatment, more potent and long-acting drugs and more effective regimens are needed.

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