Korean J Helicobacter Up Gastrointest Res.  2017 Mar;17(1):20-25. 10.7704/kjhugr.2017.17.1.20.

Role of Potassium-Competitive Acid Blockers in Helicobacter pylori Eradication

• Park JK

• KMID: 2391606
• DOI: http://doi.org/10.7704/kjhugr.2017.17.1.20

Abstract

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.

Keyword

Potassium-competitive acid blocker; Helicobacter pylori

MeSH Terms

Amoxicillin
Anti-Bacterial Agents
Clarithromycin
Drug Resistance, Microbial
Gastric Acid
Helicobacter pylori*
Helicobacter*
Hydrogen-Ion Concentration
Proton Pumps
Amoxicillin
Anti-Bacterial Agents
Clarithromycin
Proton Pumps