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Is It Time for Noncontinuous Therapy for Gastroesophageal Reflux Disease?
Steve D'Souza1, Sharon Udemba1, Ronnie Fass1
1The Esophageal and Swallowing Center, Division of Gastroenterology and Hepatology, MetroHealth System and Case Western Reserve University, Cleveland, Ohio.
Gastroenterology & Hepatology
|August 28, 2024
Summary
Proton pump inhibitors (PPIs) are standard for GERD but require daily use. Potassium-competitive acid blockers (P-CABs) show promise for convenient, noncontinuous GERD therapy due to rapid action.
Area of Science:
- Gastroenterology
- Pharmacology
Background:
- Gastroesophageal reflux disease (GERD) is a chronic condition with significant long-term complications.
- Proton pump inhibitors (PPIs) are the primary treatment but necessitate daily administration.
- Noncontinuous therapy offers patient convenience and cost benefits.
Purpose of the Study:
- To review the evidence for noncontinuous therapy in GERD.
- To compare the suitability of PPIs and potassium-competitive acid blockers (P-CABs) for noncontinuous GERD treatment.
Main Methods:
- Review of current evidence on PPIs and P-CABs in noncontinuous GERD therapy.
- Analysis of drug characteristics relevant to noncontinuous administration (e.g., speed of action, durability).
Main Results:
- PPIs are effective but limited by slow onset for on-demand treatment.
- P-CABs possess favorable pharmacokinetic and pharmacodynamic profiles for noncontinuous GERD therapy.
- Early studies suggest P-CABs are promising for noncontinuous GERD treatment.
Conclusions:
- Noncontinuous therapy is a viable option for select GERD patients.
- P-CABs represent a potentially superior option for noncontinuous GERD treatment compared to PPIs.
- Further research is needed to confirm the long-term value of P-CABs in noncontinuous GERD therapy.
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