伏诺拉生的临床应用及不良反应

Clinical application and adverse effects of Vonoprazan

富马酸伏诺拉生(Vonoprazan, TAK-438)是临床应用中引入的第二种P-CABs药物,于2020年12月28日纳入我国医保,作为第二代P-CABs药物,伏诺拉生具有独特的吡咯衍类结构,其碱性pKa为9.06的特性,促使其能在酸性环境(如胃壁细胞的细胞内小管)中高水平积累,显示出了更强的抑酸作用。除此之外,起效快、抑酸效果持续时间长、结合可逆等方面优势较传统质子泵抑制剂(proton pump inhibitors, PPIs)药物展示了更广阔的应用前景。目前伏诺拉生已被证实可以用于临床治疗胃食管反流病、消化性溃疡、H.pylori的根除以及ESD术后延迟出血等疾病。本文拟对伏诺拉生的临床应用以及不良反应进行综述。

Vonoprazan is the second P-CABs drug introduced in clinical application. It was included in China on Dec.28th, 2020. As a second-generation P-CABs, Vonoprazan has a unique pyraction structure with its alkaline pKa of 9.06, promoting its high accumulation in acid space(such as intracellular tubules of gastric wall cells), showing a stronger acid suppression effect. In addition, the advantages of fast onset, long duration of acid inhibition effect and reversible binding over traditional proton pump inhibitors(PPIs) drugs show its broad application prospects. At present, Vonoprazan has been confirmed to be used in the clinical treatment of gastroesophageal reflux disease, peptic ulcer, eradication of H.pylori, and delayed bleeding after ESD. This article reviewed the clinical application of Vonoprazan and the adverse effects.