Role of Potassium-Competitive Acid Blockers in Helicobacter pylori Eradication

The first-line therapy for Helicobacter pylori infection comprises triple therapy with the combination of a proton pump inhibitor (PPI), amoxicillin, and clarithromycin. However, the H. pylori eradication rate after PPI-based triple therapy has fallen below 80% in many countries, and even reached 70...

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Main Author: Jong Kyu Park
Format: Article
Language:English
Published: Yong Chan Lee 2017-03-01
Series:The Korean Journal of Helicobacter and Upper Gastrointestinal Research
Subjects:
Online Access:http://www.helicojournal.org/journal/view.html?doi=10.7704/kjhugr.2017.17.1.20
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author Jong Kyu Park
author_facet Jong Kyu Park
author_sort Jong Kyu Park
collection DOAJ
description The first-line therapy for Helicobacter pylori infection comprises triple therapy with the combination of a proton pump inhibitor (PPI), amoxicillin, and clarithromycin. However, the H. pylori eradication rate after PPI-based triple therapy has fallen below 80% in many countries, and even reached 70% in recent Korean studies. The main cause of eradication failure has been attributed to the increased antibiotic resistance of H. pylori. To overcome the limitations of the current eradication therapy, the maintenance of a high gastric pH, which increases the function of the antibiotics, may be a successful strategy. Potassium-competitive acid blockers (PCABs) inhibit H⁺, K⁺-ATPase in a reversible and K⁺-competitive manner and result in an almost complete inhibition of gastric acid secretion. However, the clinical development of most PCABs has been discontinued owing to their hepatic toxicity or similar efficacy to PPIs. Vonoprazan has a completely different chemical structure and higher pKa value compared with those of other PCABs and produces more potent and sustained acid inhibition. A recent phase III randomized study reported that vonoprazan was highly effective as a component of first-line or second-line triple therapy. In this study, we reviewed the literature regarding the role of PCAB in the eradication of H. pylori.
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spelling doaj.art-d50821b24f094fcf937c1d9007b901c22022-12-21T17:48:08ZengYong Chan LeeThe Korean Journal of Helicobacter and Upper Gastrointestinal Research1738-33312017-03-01171202510.7704/kjhugr.2017.17.1.20kjhugr.2017.17.1.20Role of Potassium-Competitive Acid Blockers in Helicobacter pylori EradicationJong Kyu Park0Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, KoreaThe first-line therapy for Helicobacter pylori infection comprises triple therapy with the combination of a proton pump inhibitor (PPI), amoxicillin, and clarithromycin. However, the H. pylori eradication rate after PPI-based triple therapy has fallen below 80% in many countries, and even reached 70% in recent Korean studies. The main cause of eradication failure has been attributed to the increased antibiotic resistance of H. pylori. To overcome the limitations of the current eradication therapy, the maintenance of a high gastric pH, which increases the function of the antibiotics, may be a successful strategy. Potassium-competitive acid blockers (PCABs) inhibit H⁺, K⁺-ATPase in a reversible and K⁺-competitive manner and result in an almost complete inhibition of gastric acid secretion. However, the clinical development of most PCABs has been discontinued owing to their hepatic toxicity or similar efficacy to PPIs. Vonoprazan has a completely different chemical structure and higher pKa value compared with those of other PCABs and produces more potent and sustained acid inhibition. A recent phase III randomized study reported that vonoprazan was highly effective as a component of first-line or second-line triple therapy. In this study, we reviewed the literature regarding the role of PCAB in the eradication of H. pylori.http://www.helicojournal.org/journal/view.html?doi=10.7704/kjhugr.2017.17.1.20Potassium-competitive acid blockerHelicobacter pylori
spellingShingle Jong Kyu Park
Role of Potassium-Competitive Acid Blockers in Helicobacter pylori Eradication
The Korean Journal of Helicobacter and Upper Gastrointestinal Research
Potassium-competitive acid blocker
Helicobacter pylori
title Role of Potassium-Competitive Acid Blockers in Helicobacter pylori Eradication
title_full Role of Potassium-Competitive Acid Blockers in Helicobacter pylori Eradication
title_fullStr Role of Potassium-Competitive Acid Blockers in Helicobacter pylori Eradication
title_full_unstemmed Role of Potassium-Competitive Acid Blockers in Helicobacter pylori Eradication
title_short Role of Potassium-Competitive Acid Blockers in Helicobacter pylori Eradication
title_sort role of potassium competitive acid blockers in helicobacter pylori eradication
topic Potassium-competitive acid blocker
Helicobacter pylori
url http://www.helicojournal.org/journal/view.html?doi=10.7704/kjhugr.2017.17.1.20
work_keys_str_mv AT jongkyupark roleofpotassiumcompetitiveacidblockersinhelicobacterpylorieradication