A Patel et al. Gastroenterology. 2024: 6: 1228 – 1238. Open Access! AGA Clinical Practice Update on Integrating Potassium-Competitive Acid Blockers Into Clinical Practice: Expert Review

Best Practice Advice (for adults):

• Potassium-competitive acid blockers are generally not recommended as first line therapy. This rationale is based on cost, greater obstacles to obtaining medication, and fewer long-term safety data.
• Clinicians may use P-CABs in selected patients with documented acid-related reflux & erosive esophagitis who fail therapy with twice-daily PPIs.
• Clinicians should use P-CABs in place of PPIs in eradication regimens for most patients with H pylori infection.
• P-CABs may be beneficial in high-risk bleeding peptic ulcer disease. “Although there is currently insufficient evidence for clinicians to use P-CABs as first-line therapy in patients with bleeding gastroduodenal ulcers and high-risk stigmata, their rapid and potent acid inhibition raises the possibility of their utility in this population.”

Related blog posts:

• Is Vonoprazan Better Than Intravenous PPIs for High-Risk Peptic Ulcers?
• Improved Efficacy with Vonoprazan for Severe Esophagitis
• Why Vonoprazan Is More Effective For Erosive Esophagitis Than a Proton Pump Inhibitor
• Understanding FDA Approval of Vonoprazan-Based Therapies for Helicobacter Pylori
• Safety and Efficacy of Potassium Competitive Acid Blockers (3 Studies)
• All Bleeding Stops (part 2)
• All bleeding stops