Potassium-competitive acid blockers and advances in the management of patients with acid-related diseases: a narrative review

Traditional management of acid-related diseases, including gastroesophageal reflux disease, <i>Helicobacter pylori</i> infection, and peptic ulcer disease, primarily relies on proton pump inhibitors, which have notable limitations in acid suppression efficacy that hinder optimal treatment outcomes. Potassium-competitive acid blockers offer a novel approach with improved pharmacokinetic and pharmacodynamic properties, enhancing acid suppression and clinical efficacy in acid-related disease management. This narrative review evaluates the role of potassium-competitive acid blockers in acid-related disease management, comparing the pharmacokinetic, pharmacodynamic, clinical efficacy, and safety profiles of currently available agents. A comprehensive literature search from January 2002 to June 2024 was conducted across multiple databases to gather data on the efficacy and safety of potassium-competitive acid blockers. Potassium-competitive acid blockers showed comparable or superior clinical efficacy and generally comparable safety in various clinical settings vs. comparator proton pump inhibitors, particularly in managing erosive esophagitis, <i>H. pylori</i> eradication, and peptic ulcer disease. Potassium-competitive acid blockers, of which vonoprazan is the most well studied, offer comparable or improved therapeutic outcomes over traditional proton pump inhibitors, making them a valid option for several acid-related disease indications.