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World J Gastrointest Pharmacol Ther. 2018 Dec 13;9(7):63-68. doi: 10.4292/wjgpt.v9.i7.63.

Potassium-competitive acid blockers - are they the next generation of proton pump inhibitors?

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Department of Internal Medicine, SOVAH Health, Martinsville, VA 24112, United States.
Division of Gastroenterology and Hepatology, The Brooklyn Hospital Center, Clinical Affiliate of The Mount Sinai Hospital, New York, NY 11201, United States.
Division of Gastroenterology, SBH Health System, Bronx, NY 10457, United States.


The modern lifestyle caters to an increase in the incidence of peptic ulcer disease, gastroesophageal reflux disease and several other acid-related conditions of the gut. The drugs to prevent these conditions work either through H2 receptor blockade or inhibition of the H+, K+ ATPase enzyme. Although proton pump inhibitors have been proven to be efficacious, they have a slow onset of action with limited resolution of symptoms in most patients. Potassium-competitive acid blockers (P-CABs) are novel drugs that bind reversibly to K+ ions and block the H+, K+ ATPase enzyme, thus preventing acid production. P-CABs have a fast onset of action and have dose-dependent effects on acid production. Animal studies exist that differentiate the better results of P-CABs from proton pump inhibitors; further human trials will give a comprehensive picture of the results and will help to elucidate the therapeutic benefits of this new group of drugs.


Gastroesophageal reflux disease; Peptic ulcer disease; Potassium-competitive acid blockers; Proton pump inhibitors; Vonoprazan

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Conflict-of-interest statement: All authors have no conflicts of interest to report.

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