P-CABs类药物用于治疗胃食管反流病的 疗效进展
Efficacy Advances of P-CABs in the Treatment of Gastroesophageal Reflux Disease
摘要: 钾离子竞争性酸阻滞剂(P-CABs)代表了胃食管反流病(GERD)抑酸治疗的重要进展。与质子泵抑制剂(PPIs)相比，P-CABs具有起效更快、抑酸更强且不受CYP2C19代谢型影响的药理学优势。关键III期临床研究证实，伏诺拉生、替戈拉生、凯普拉生等P-CABs在糜烂性食管炎(EE)的8周黏膜愈合率上非劣于甚至优效于PPIs，这一优势在重度食管炎(LA C/D级)及PPI应答不佳患者中尤为显著。此外，P-CABs在长期维持治疗中也展现出低复发率的有效性。结论认为，P-CABs为GERD，尤其是中重度及难治性病例，提供了更优的初始和维持治疗选择。
Abstract: Potassium-competitive acid blockers (P-CABs) represent a significant advance in acid-suppressive therapy for gastroesophageal reflux disease (GERD). Compared with proton pump inhibitors (PPIs), P-CABs offer pharmacological advantages including faster onset, stronger acid suppression, and independence from CYP2C19 metabolic phenotypes. Key phase III clinical trials have confirmed that P-CABs such as vonoprazan, tegoprazan, and keverprazan are non-inferior or even superior to PPIs in terms of 8-week mucosal healing rates for erosive esophagitis (EE). This advantage is particularly pronounced in patients with severe esophagitis (LA grades C/D) and those with an inadequate response to PPIs. Furthermore, P-CABs have demonstrated effectiveness in long-term maintenance therapy with low recurrence rates. In conclusion, P-CABs provide a superior option for both initial and maintenance treatment of GERD, especially in moderate-to-severe and refractory cases.
文章引用：陈乐天, 古赛. P-CABs类药物用于治疗胃食管反流病的 疗效进展[J]. 临床医学进展, 2026, 16(3): 350-355. https://doi.org/10.12677/acm.2026.163798

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