Association of Physicians of India Consensus Recommendations for Vonoprazan in Management of Acid Peptic Disorders

The suppression of gastric acid secretion has long been the cornerstone of treatment for acid peptic disorders (APDs). Proton pump inhibitors (PPIs) have played a central role in managing these conditions, but their effectiveness can be hindered by notable limitations such as refractoriness or treatment failure due to inadequate acid suppression in some gastroesophageal reflux disease (GERD) patients, nonadherence to prescribed regimens due to the complexity of dosing, variability of response, and nocturnal acid breakthrough, etc. Vonoprazan is a first-in-class potassium-competitive acid blocker (P-CAB), recently introduced in India and also approved in several countries such as Japan, South Korea, and the USA. Extensive clinical evidence suggests that vonoprazan offers more potent acid suppression than PPIs. This consensus from the Association of Physicians of India (API) has been developed with the objective of providing key recommendations for the appropriate clinical usage of vonoprazan across various subsets of APDs, thereby optimizing the existing therapeutic options and improving the care and management of APD patients.