ABSTRACT

Introduction

Patients with acid-related disorders (ARDs) of the upper digestive tract remain highly prevalent and need to be continuously investigated to improve their management.

Areas covered

This review provides a summary of the most recent advancements in the treatment of ARDs with particular focus on the new drugs available to overcome the unmet needs of traditional therapies.

Expert opinion

Proton pump inhibitors remain the best therapy in treating ARDs, but a consistent proportion of these patients continues to present mucosal lesions or to experience symptoms despite treatment. These cases pertain mainly to the most severe forms of erosive esophagitis or to non-erosive reflux disease. Also, the increasing rate of patients with H. pylori infection not responding to eradication therapy represents a difficult clinical condition. The recent advent of a new class of antisecretory drugs, such as the potassium competitive acid blockers and, among them the most studied vonoprazan, which are characterized by a better pharmacological profile than PPIs (rapid onset of action, longer lasting acid suppression, control of nocturnal acidity), has the potential to overcome the above-mentioned unmet needs. More research should be done to assess their efficacy in Western populations and their safety in patients treated in the long term.

中文翻译：

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沃诺拉赞治疗酸相关疾病的药理学、疗效和安全性更新

摘要

介绍

患有上消化道酸相关疾病 (ARD) 的患者仍然非常普遍，需要不断进行调查以改善他们的管理。

涵盖的领域

本综述总结了急性呼吸道疾病治疗的最新进展，特别关注可用于克服传统疗法未满足需求的新药。

专家意见

质子泵抑制剂仍然是治疗急性呼吸道疾病的最佳疗法，但这些患者中有一致的比例继续出现粘膜病变或尽管接受了治疗，但仍会出现症状。这些病例主要与最严重的糜烂性食管炎或非糜烂性反流病有关。此外，越来越多的幽门螺杆菌感染患者对根除治疗无反应，这代表了一种困难的临床状况。最近出现了一类新的抗分泌药物，例如钾竞争性酸阻滞剂，其中研究最多的沃诺拉赞，其特点是比 PPI 具有更好的药理学特征（起效快、抑制酸持续时间更长、控制夜间酸度），有可能克服上述未满足的需求。