Objective: To review the safety, efficacy, and tolerability of
vonoprazan for the treatment of Helicobacter pylori
infection in adults. Data Sources: A literature search was performed through PubMed using the following key terms:
vonoprazan, Voquezna,
TAK-438,
potassium-competitive
acid blocker, H pylori, and gastrointestinal. Study Selection and Data Extraction: Selected articles included those which described clinical studies of the pharmacology, pharmacokinetics, efficacy, safety, or tolerability of
vonoprazan. Data Synthesis:
Vonoprazan works by competing with
potassium on the
proton pump to inhibit gastric acid secretion. Phase 3 clinical trials have shown that
vonoprazan is noninferior to
proton pump inhibitors (PPIs) as a component of H pylori eradication regimens.
Vonoprazan has also shown promise in
duodenal ulcer-healing rates and in reducing symptoms of
heartburn. Common adverse effects associated with
vonoprazan include
nasopharyngitis,
diarrhea,
constipation,
flatulence,
dyspepsia,
headache, and
abdominal pain. Conclusion: Clinical practice guidelines recommend PPIs as the antisecretory agent of choice in H pylori eradication regimens with histamine-2 receptor antagonists (H2RAs) as potential alternatives. However, the use of either class of medications may be limited by adverse effects, drug interactions, and tolerability.
Potassium-competitive
acid blockers (P-CABs), like
vonoprazan, may be safe and effective alternative antisecretory agents for H pylori eradication regimens, as well as other
gastrointestinal disorders.