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Zastaprazan, a Novel Potassium-Competitive Acid Blocker, for Acid-Related Disorders.

Gwang Ha Kim^1,2, Dong Chan Joo^1,2, Moon Won Lee^1,2

¹Department of Internal Medicine, Pusan National University School of Medicine, Busan 49241, Republic of Korea.

Journal of Clinical Medicine

|May 27, 2026

Summary

Zastaprazan, a potassium-competitive acid blocker (P-CAB), offers advantages over proton pump inhibitors (PPIs) for acid-related disorders. Clinical trials show its comparable or superior efficacy and safety in healing erosive esophagitis and gastric ulcers.

Keywords:

acid-related disorders gastric ulcer gastroesophageal reflux disease potassium-competitive acid blockers zastaprazan

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Area of Science:

Pharmacology and Therapeutics
Gastroenterology

Background:

Proton pump inhibitors (PPIs) are first-line treatments for acid-related disorders but have limitations.
These limitations include acid-mediated activation, short half-life, and metabolic variability.

Purpose of the Study:

To review the pharmacology, efficacy, and safety of zastaprazan, a novel potassium-competitive acid blocker (P-CAB).
To compare zastaprazan's profile with existing PPIs for acid suppression.

Main Methods:

Review of completed clinical trials and published literature on zastaprazan.
Pharmacodynamic and pharmacokinetic property analysis.
Efficacy and safety data comparison with PPIs.

Main Results:

Zastaprazan demonstrated rapid, robust, and long-lasting acid suppression.
It showed comparable or superior efficacy to PPIs in healing erosive esophagitis and gastric ulcers.
Zastaprazan exhibited a favorable safety profile without concerning signals.

Conclusions:

Zastaprazan presents potential advantages over PPIs due to its distinct mechanism of action and pharmacokinetic profile.
It is a promising therapeutic option for acid-related disorders, with ongoing trials for broader applications.