Editorial: “Stardust gastric mucosa” – A novel and consistent marker of vonoprazan safety during follow‐up?

Luu, Maxime; Ghezala, Inès Ben; Bardou, Marc

doi:10.1111/apt.16198

Cited by 2 publications

(1 citation statement)

References 8 publications

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“…Although a correlation between hypergastrinemia and stardust gastric mucosal change was reported, a causal relationship is not evident. Although concerns were raised regarding the possible associated development of neuroendocrine neoplasia, 62 these are allayed by the fact that stardust gastric mucosal change is also observed in patients treated with PPIs, drugs that have been safely in us for over 30 years. Although there is no evident association with neoplastic change, further large studies are necessary to elucidate the mechanism of development of stardust gastric mucosal change and its long‐term natural history.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic findings and outcomes of gastric mucosal changes relating to potassium‐competitive acid blocker and proton pump inhibitor therapy

Shinozaki,

Osawa,

Miura

et al. 2024

DEN Open

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Gastric mucosal changes associated with long‐term potassium‐competitive acid blocker and proton pump inhibitor (PPI) therapy may raise concern. In contrast to that for PPIs, the evidence concerning the safety of long‐term potassium‐competitive acid blocker use is scant. Vonoprazan (VPZ) is a representative potassium‐competitive acid blocker released in Japan in 2015. In order to shed some comparative light regarding the outcomes of gastric mucosal lesions associated with a long‐term acid blockade, we have reviewed six representative gastric mucosal lesions: fundic gland polyps, gastric hyperplastic polyps, multiple white and flat elevated lesions, cobblestone‐like gastric mucosal changes, gastric black spots, and stardust gastric mucosal changes. For these mucosal lesions, we have evaluated the association with the type of acid blockade, patient gender, Helicobacter pylori infection status, the degree of gastric atrophy, and serum gastrin levels. There is no concrete evidence to support a significant relationship between VPZ/PPI use and the development of neuroendocrine tumors. Current data also shows that the risk of gastric mucosal changes is similar for long‐term VPZ and PPI use. Serum hypergastrinemia is not correlated with the development of some gastric mucosal lesions. Therefore, serum gastrin level is unhelpful for risk estimation and for decision‐making relating to the cessation of these drugs in routine clinical practice. Given the confounding potential neoplastic risk relating to H. pylori infection, this should be eradicated before VPZ/PPI therapy is commenced. The evidence to date does not support the cessation of clinically appropriate VPZ/PPI therapy solely because of the presence of these associated gastric mucosal lesions.

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Section: Introductionmentioning

confidence: 99%

Endoscopic findings and outcomes of gastric mucosal changes relating to potassium‐competitive acid blocker and proton pump inhibitor therapy

Shinozaki,

Osawa,

Miura

et al. 2024

DEN Open

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Review article: potassium‐competitive acid blockers for the treatment of acid‐related disorders

Abdel-Aziz

Metz

Howden

2021

Aliment Pharmacol Ther

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SummaryBackgroundPotassium‐competitive acid blockers (P‐CABs) are a novel group of acid‐suppressing medicines for the management of acid‐related disorders.AimsTo review published clinical pharmacology studies and clinical trials of P‐CABs.MethodsWe conducted a comprehensive literature search including Medline (PubMed), EMBASE, Web of Science and the Cochrane Library from inception until November 2020, for studies of the clinical pharmacology of P‐CABs and relevant clinical trials of those that are currently licensed or in development.ResultsMost publications concerned vonoprazan, which forms the bulk of this review. It is currently licensed in some Asian and South American countries and is being developed for North America. In clinically relevant doses, P‐CABs have produced more rapid and profound suppression of intragastric acidity than proton pump inhibitors (PPIs). Vonoprazan was non‐inferior to lansoprazole in healing erosive oesophagitis (2 randomised controlled trials [RCTs] in 1137 subjects) and superior in maintaining remission (1 RCT; 607 subjects). In 2 RCTs (1120 total subjects), both vonoprazan and tegoprazan were non‐inferior to lansoprazole for healing peptic ulcers. Three RCTs and numerous non‐randomised studies have compared vonoprazan‐based and PPI‐based regimens for Helicobacter pylori infection; vonoprazan‐based triple or dual regimens have been highly effective.ConclusionsP‐CABs have some potential advantages over PPIs. To date, most research has been conducted in Asia; results of clinical trials that are underway in the United States and Europe are anticipated in 2021.

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Editorial: “Stardust gastric mucosa” – A novel and consistent marker of vonoprazan safety during follow‐up?

Abstract: LINKED CONTENT This article is linked to Yoshizaki et al paper. To view these article, visit https://doi.org/10.1111/apt.16151

Cited by 2 publications

References 8 publications

Endoscopic findings and outcomes of gastric mucosal changes relating to potassium‐competitive acid blocker and proton pump inhibitor therapy

Endoscopic findings and outcomes of gastric mucosal changes relating to potassium‐competitive acid blocker and proton pump inhibitor therapy

Review article: potassium‐competitive acid blockers for the treatment of acid‐related disorders

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