Characteristics of the Novel Potassium-Competitive Acid Blocker Vonoprazan Fumarate (TAK-438)

Otake, Kazuyoshi; Sakurai, Yuuichi; Nishida, Haruyuki; Fukui, Hirokazu; Tagawa, Yoshihiko; Yamasaki, Hitomi; Karashima, Masatoshi; Otsuka, Kyoko; Inatomi, Nobuhiro

doi:10.1007/s12325-016-0345-2

Cited by 74 publications

(61 citation statements)

References 56 publications

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“…15 We used high-dose lansoprazole to maintain the intragastric pH above 4 and stabilize the antibiotics. 45,46 Although vonoprazan 16 (a potassium-competitive acid blocker) can achieve more rapid and sustained control of the intragastric pH at 6 or above to stimulate the replication of H. pylori and increase the bactericidal efficacy of antibiotics, 17,46 it is currently not available in Taiwan.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 This is attributable to the special gastric milieu of H. pylori, which leads to more difficult and complicated treatment regimens to achieve its successful eradication in contrast to other bacterial infections. Several strategies [7][8][9] have been proposed to increase the eradication rate and decrease the antibiotic resistance, including extension of treatment duration, increasing doses, using four-drug nonbismuth-containing (sequential, hybrid, and concomitant) and bismuth-containing quadruple therapies or even five-drug quintuple therapy, 10 use of other antibiotics such as levofloxacin, 9 azithromycin, 11 rifabutin, 12,13 and furazolidone, 14 using a high-dose proton pump inhibitor 15 or a novel potassium-competitive acid blocker (vonoprazan), [16][17][18] dual therapy, 8 use of bismuth-enhanced triple therapy 19 or susceptibility-guided therapy, [20][21][22] and the supplementation of probiotics. 8,23,24 However, the current multiple-dose antibiotic therapies still steadily increase the rate of worldwide antibiotic resistance, which becomes a leading international medical problem.…”

Section: Introductionmentioning

confidence: 99%

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Intraluminal therapy for Helicobacter pylori infection

Liou

Liao

Lin

et al. 2019

J of Gastro and Hepatol

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Background and Aim Several strategies have been proposed to increase the eradication rate of Helicobacter pylori. However, the widespread increasing resistance rates to current multiple‐dose oral antibiotic therapies call for alternative therapeutic approaches. We aim to develop a novel intraluminal therapy for H. pylori infection (ILTHPI). Methods From April 2017 to December 2017, 100 H. pylori‐infected treatment‐naïve patients with upper abdominal pain or discomfort underwent endoscopic examinations and concomitant ILTHPI, which comprised the control of intragastric pH, the irrigation of gastric mucosal surface with a mucolytic agent, and the application of single‐dose medicaments containing antibiotic powders. The safety profiles while conducting ILTHPI and adverse events after ILTHPI were evaluated. The success of eradication was assessed based on the result of the 13C‐urea breath test 6 weeks after ILTHPI. In addition, a patient with successful ILTHPI was reconfirmed by a negative H. pylori stool antigen test four to 6 months after ILTHPI to exclude short‐term recurrence. Results All the 100 enrolled patients completed the ILTHPI with good safety profiles and mild adverse events (6%). Five patients dropped out, and 51 of 95 patients (53.7%) achieved successful eradication immediately after endoscopic examinations. All 51 patients revealed negative stool H. pylori antigen tests four to 6 months after successful ILTHPI. No short‐term recurrence was observed. Conclusions We have developed a novel therapeutic approach. With the ILTHPI, H. pylori can be eradicated immediately by administrating a single‐dose regimen while conducting an endoscopic examination. Clinical Trials Number NCT03124420

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Intraluminal therapy for Helicobacter pylori infection

Liou

Liao

Lin

et al. 2019

J of Gastro and Hepatol

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“…The reason why smoking (and other lifestyle-related factors) did not increase the eradication failure rate was not clear. The potent gastric acid suppression induced by vonoprazan might conceal the effect of lifestyle-related factors [6,[22][23][24]49]. Furthermore, the number of the subjects in the study was limited from this point of view.…”

Section: Discussionmentioning

confidence: 99%

“…P-CAB inhibits H + , K + -ATPase-mediated gastric acid secretion, and vonoprazan suppresses gastric acid secretion more potently than PPIs [22][23][24]. There have been many studies indicating that H. pylori eradication with triple therapy including vonoprazan is more efficient compared with eradication using PPIs [25][26][27][28][29][30][31][32][33][34][35][36].…”

Section: Introductionmentioning

confidence: 99%

Smoking and Drinking Did Not Increase the Failure of Therapeutic Helicobacter pylori Eradication by Vonoprazan, Clarithromycin, and Amoxicillin

Takara¹,

Endo²,

Nakano³

et al. 2018

Digestion

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Aims: The influence of lifestyle-related factors, including smoking and drinking, was evaluated for Helicobacter pylori eradication therapy with vonoprazan or proton pump inhibitors (PPIs). Methods: Between 2012 and 2016, the medical records of 620 patients receiving H. pylori eradication therapy at Saiseikai Karatsu Hospital were evaluated. Patients had received vonoprazan (20 mg) or PPIs with 200 mg clarithromycin and 750 mg amoxicillin twice daily for 7 days. The influence of lifestyle-related factors on eradication failure was determined in the 2 groups. Results: The eradication rates for vonoprazan and lansoprazole, rabeprazole, and esomeprazole were, respectively, 91.0, 73.8, 72.0, and 84.6%. The vonoprazan eradication rate was significantly higher than those for the PPIs (p < 0.01). Habitual smoking and drinking did not increase eradication failure, and smoking and drinking during the eradication period did not reduce the eradication rate. Metabolic syndrome-related factors including obesity, hypertension, and diabetes mellitus had no negative influence on the eradication rate. Eradication with vonoprazan was more effective compared with that achieved through the use of PPIs. Conclusion: Lifestyle-related factors including smoking and drinking did not exacerbate the H. pylori eradication failure, and vonoprazan was more effective than the PPIs.

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“…Finally, a novel potassium‐competitive acid blocker has been developed to resolve the limitations of conventional PPIs. Initial clinical trials have been very encouraging; however, long‐term efficacy and possible side effects need still to be evaluated …”

Section: Alteration Of Clopidogrel Pharmacodynamics and Cardiovasculamentioning

confidence: 99%

Proton pump inhibitors: Risks of long‐term use

Eusebi

Rabitti

Artesiani

et al. 2017

J of Gastro and Hepatol

166

145

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Proton pump inhibitors are among the most commonly prescribed classes of drugs, and their use is increasing, in particular for long-term treatment, often being over-prescribed and used for inappropriate conditions. In recent years, considerable attention has been directed towards a wide range of adverse effects, and even when a potential underlying biological mechanism is plausible, the clinical evidence of the adverse effect is often weak. Several long-term side effects have been investigated ranging from interaction with other drugs, increased risk of infection, reduced intestinal absorption of vitamins and minerals, and more recently kidney damage and dementia. The most recent literature regarding these adverse effects and their association with long-term proton pump inhibitor treatment is reviewed, and the mechanisms through which these possible complications might develop are discussed.

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Characteristics of the Novel Potassium-Competitive Acid Blocker Vonoprazan Fumarate (TAK-438)

Abstract: This review project, including the publication of this article, was funded by Takeda Pharmaceutical Company Limited.

Cited by 74 publications

References 56 publications

Intraluminal therapy for Helicobacter pylori infection

Intraluminal therapy for Helicobacter pylori infection

Smoking and Drinking Did Not Increase the Failure of Therapeutic Helicobacter pylori Eradication by Vonoprazan, Clarithromycin, and Amoxicillin

Proton pump inhibitors: Risks of long‐term use

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