Potassium-Competitive Acid Blockers (P-CABs): Are They Finally Ready for Prime Time in Acid-Related Disease?

The need for new acid suppressing agents with improved pharmacology and superior antisecretory effects to address unmet clinical needs in acid-related disorders has been evident for over a decade. Recent new antisecretory drugs (IR-omeprazole and MR-dexlansoprazole) only provide a small incremental advance in control of acid secretion over the delayed-release proton pump inhibitors. Vonoprazan (a new potassium-competitive acid blocker) displays more potent and extended 24 h acid suppression and preliminary Japanese trials translate this into meaningful clinical benefits in gastroesophageal reflux disease and Helicobacter pylori eradication. We review the vonoprazan information to date and the indications, benefits, and concerns of more effective therapeutic control of acid secretion.