Vonoprazan pharmacokinetics and effects on gastric pH following administration to fed and fasted horses.
Authors: Morales Camilo J, Sykes Benjamin W, McKemie Daniel S, Kass Philip H, Knych Heather K
Journal: Equine veterinary journal
Summary
# Editorial Summary: Vonoprazan in Equine Gastric Ulcer Management Vonoprazan, a potassium-competitive acid blocker (P-CAB), represents a pharmacologically distinct alternative to omeprazole for managing equine gastric ulcer syndrome, with the potential advantage of efficacy regardless of feeding status—a significant practical consideration given the logistical challenges of administering conventional proton pump inhibitors on an empty stomach. This investigation characterised vonoprazan's pharmacokinetics and gastric acid suppression in both fed and fasted horses, thereby addressing a critical gap in equine therapeutic knowledge. The researchers documented vonoprazan's absorption kinetics, plasma concentrations, and intragastric pH changes across different feeding conditions, providing data on whether meal timing compromises drug efficacy as it does with omeprazole. Results demonstrated that vonoprazan maintains meaningful gastric pH elevation irrespective of feed intake, with specific pharmacokinetic parameters favouring clinical use in working and competition horses where fasting protocols are impractical. These findings suggest vonoprazan could substantially improve treatment compliance and reduce management burden in equine practice, particularly for performance animals requiring consistent ulcer prophylaxis without rigid feeding restrictions, though further efficacy and safety data in naturally occurring EGUS cases would strengthen the clinical case for adoption.
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Practical Takeaways
- •Vonoprazan may offer a practical alternative to omeprazole for EGUS treatment, with potential for administration regardless of feeding status—improving compliance and management ease
- •This newer drug class warrants evaluation in equine practice as it demonstrates advantages over current standard PPI therapy in other species
- •Further clinical trials are needed to establish efficacy, dosing, and safety profiles in horses before routine clinical adoption
Key Findings
- •Vonoprazan is a potassium-competitive acid blocker (P-CAB) representing a newer class of acid suppressants for equine gastric ulcers
- •P-CABs offer several advantages over proton pump inhibitors (PPIs) like omeprazole in human medicine
- •Unlike omeprazole, vonoprazan may not require administration on an empty stomach in horses
- •Study examined vonoprazan pharmacokinetics and gastric pH effects in both fed and fasted horses