Potassium-competitive acid blockers and gastroesophageal reflux disease

Proton pump inhibitors(PPIs),the most commonly used antisecretory medications in the management of reflux illness,virtually eliminate elective surgery for ulcer disease,and relegate anti-reflux surgery to patients with gastroesophageal reflux disease(GERD) who are inadequately managed by medical therapy.However,PPI medications still leave some therapeutic demands of GERD unmet.Furthermore,up to 40%-55% of daily PPI users have chronic symptoms,due to PPI refractoriness.Potassium-competitive acid blockers(P-CABs) transcend many of the problems and limits of PPIs,delivering quick,powerful,and extended acid suppression and allowing for treatment of numerous unmet needs.Recently,it has become clear that compromised mucosal integrity plays a role in the etiology of GERD.As a result,esophageal mucosal protection has emerged as a novel and potential treatment approach.An increasing body of research demonstrates that when P-CABs are used as primary drugs or add-on drugs(to regular treatment),they provide a considerable extra benefit,particularly in alleviating symptoms that do not respond to PPI therapy.