Discerning the MOA of Vonoprazan in Gastric Acid Management, Gastroenterology, Gastroenterologist, Vonoprazan, Vono, Gastric Acid, Gastro
Identifying the mode of action of vonoprazan for digestive acid control. Explore the clinical intricacies of vonoprazan in managing gastric acid.
Proton pump inhibitors (PPIs), the conventional drugs for gastric acid management, have recently come under scrutiny due to several drawbacks.1 These include slow onset of action, incomplete acid control, and mealtime dependency, which prevent PPIs from being the optimal anti-secretory agents for gastric acid management.2 Vonoprazan, a novel potassium-competitive acid blocker (P-CAB), has emerged as the first-choice drug for various gastric acid complications.3
The mechanism of action (MOA) of vonoprazan is unique. Unlike PPIs, it typically does not need an acidic environment for activation.4 Instead, vonoprazangets accumulated in the acidic secretory canaliculus of parietal cells and competes with potassium ions for the reversible inhibition of hydrogen-potassium adenosine triphosphatases (H+/K+-ATPases).1,5 This results in slow dissociation rate from H+/K+-ATPases ensuring prolonged acid suppression.1
Non-ionic vonoprazan, when reduced in a strong acidic secretory canaliculi, inhibits its passive transport to the cytoplasm.1 Consequently, it remains in the parietal cells for extended periods, allowing it to inhibit the H+/K+-ATPases that are activated by further stimulation of acid secretion.1 Remarkably, vonoprazan’s inhibitory effect on H+/K+-ATPases is around 350 times greater than lansoprazole, a well-known PPI.5 Last but not least, the drug inhibits both active and inactive proton pumps, offering comprehensive acid control.4
Let’s hear to what Prof. Hidekazu Suzuki has to say about the mechanism of action of Vonoprazan in gastric acid management.
Conclusion
Vonoprazan has become the first-choice drug for diverse gastric acid complications due to superior MOA.3 It provides reversible binding to H+/K+-ATPases, does not need an acid milieu for activation, and inhibits both active and inactive proton pumps.1,4,5This novel approach addresses the unmet needs posed by conventional PPIs, marking a significant advancement in the management of gastric acid-related diseases.
References
- Oshima T, Miwa H. Potent potassium-competitive acid blockers: A new era for the treatment of acid-related diseases. J Neurogastroenterol Motil. 2018;24(3):334–344.
- Herszényi L, Bakucz T, Barabás L, et al. Pharmacological approach to gastric acid suppression: Past, present, and future. Dig Dis. 2020;38(2):104–111.
- Shinozaki S, Osawa H, Hayashi Y, et al. Long-term vonoprazan therapy is effective for controlling symptomatic proton pump inhibitor-resistant gastroesophageal reflux disease. Biomed Rep. 2021;14(3):32.
- Veererathinakumar NK, Ananthy V, Codi RS, et al. Potassium-competitive acid blocker: A newer target in the treatment of acid peptic disorder. SBV J. Basic Clin. Appl. Health Sci. 2023;6(2):33–38.
- Ishida M, Tsuchiya M, Naito J, et al. Vonoprazan-associated nephrotoxicity: Extensive real-world evidence from spontaneous adverse drug reaction reports. Kidney Int. 2022;102(3):666–668.
For the use of a registered medical practitioner, hospital or laboratory only.
LMRC Code: GGI-CO-A1-AQS-300041558-APPEMC-G24-1178 DOI of 15/07/24 and DOE of 15/08/24
Vono 20-Always on Duty
Vono, containing Vonoprazan molecule, is a Potassium Competitive Acid Blocker which helps in treatment of Refractory GERD, Erosive Esophagitis, H.Pylori, Gastric & Duodenal Ulcers
