Prescription trends of gastric acid suppressants and association with potential adverse events in Korea: a real-world cross-sectional study

Background: Recent changes in the acid-related disease market, particularly the emergence of potassium-competitive acid blockers (P-CABs), require an updated analysis of trends in gastric acid suppressant utilization. Objectives: As the use of P-CAB expands globally, a cross-sectional study is neede...

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Main Authors: Min Jeong Je, Jeong Min Go, Shin Yeong Kim, Min-Gul Kim, Hankil Lee, Ha-Lim Jeon, Jae Hyun Kim
Format: Article
Language:English
Published: SAGE Publishing 2025-07-01
Series:Therapeutic Advances in Gastroenterology
Online Access:https://doi.org/10.1177/17562848251356406
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author Min Jeong Je
Jeong Min Go
Shin Yeong Kim
Min-Gul Kim
Hankil Lee
Ha-Lim Jeon
Jae Hyun Kim
author_facet Min Jeong Je
Jeong Min Go
Shin Yeong Kim
Min-Gul Kim
Hankil Lee
Ha-Lim Jeon
Jae Hyun Kim
author_sort Min Jeong Je
collection DOAJ
description Background: Recent changes in the acid-related disease market, particularly the emergence of potassium-competitive acid blockers (P-CABs), require an updated analysis of trends in gastric acid suppressant utilization. Objectives: As the use of P-CAB expands globally, a cross-sectional study is needed to assess its association with potential adverse events from a pharmacovigilance perspective. Design: Cross-sectional study. Methods: We analyzed gastric acid suppressant use at prescription and patient levels using the Health Insurance Review and Assessment National Patient Sample database (2014–2020). Prescription-level analysis included the annual prescriptions for histamine-2 receptor antagonists (H2RAs), proton pump inhibitors (PPIs), and P-CABs, and proportion of visits by acid-related indications. Patient-level analysis examined annual trends in drug use and clinical characteristics. Logistic regression was used to estimate prevalence odds ratios (ORs) for potential adverse events among drug users and non-users according to the drug class. Results: In 2020, H2RAs were primarily prescribed for gastritis and duodenitis (64.5%), whereas PPIs (55.4%) and P-CABs (58.6%) were primarily used to treat gastroesophageal reflux disease. H2RA prescriptions declined in 2019, whereas the use of P-CAB increased following the approval of tegoprazan in 2018. Patients aged 40–64 years and female users were predominant across all classes of gastric acid suppressants. P-CAB use was significantly associated with osteoporosis (OR = 1.17; 95% confidence interval (CI): 1.13–1.20), pneumonia (OR = 1.65, 95% CI: 1.55–1.75), and acute kidney injury (OR = 1.39, 95% CI: 1.20–1.61). Conclusion: P-CABs have reshaped the prescription landscape of gastric acid suppressants. Further longitudinal cohort studies are required to evaluate long-term safety in routine clinical practice.
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spelling doaj-art-0b8bc36e16d1408a992c99f3a0a8d77b2025-07-15T16:03:36ZengSAGE PublishingTherapeutic Advances in Gastroenterology1756-28482025-07-011810.1177/17562848251356406Prescription trends of gastric acid suppressants and association with potential adverse events in Korea: a real-world cross-sectional studyMin Jeong JeJeong Min GoShin Yeong KimMin-Gul KimHankil LeeHa-Lim JeonJae Hyun KimBackground: Recent changes in the acid-related disease market, particularly the emergence of potassium-competitive acid blockers (P-CABs), require an updated analysis of trends in gastric acid suppressant utilization. Objectives: As the use of P-CAB expands globally, a cross-sectional study is needed to assess its association with potential adverse events from a pharmacovigilance perspective. Design: Cross-sectional study. Methods: We analyzed gastric acid suppressant use at prescription and patient levels using the Health Insurance Review and Assessment National Patient Sample database (2014–2020). Prescription-level analysis included the annual prescriptions for histamine-2 receptor antagonists (H2RAs), proton pump inhibitors (PPIs), and P-CABs, and proportion of visits by acid-related indications. Patient-level analysis examined annual trends in drug use and clinical characteristics. Logistic regression was used to estimate prevalence odds ratios (ORs) for potential adverse events among drug users and non-users according to the drug class. Results: In 2020, H2RAs were primarily prescribed for gastritis and duodenitis (64.5%), whereas PPIs (55.4%) and P-CABs (58.6%) were primarily used to treat gastroesophageal reflux disease. H2RA prescriptions declined in 2019, whereas the use of P-CAB increased following the approval of tegoprazan in 2018. Patients aged 40–64 years and female users were predominant across all classes of gastric acid suppressants. P-CAB use was significantly associated with osteoporosis (OR = 1.17; 95% confidence interval (CI): 1.13–1.20), pneumonia (OR = 1.65, 95% CI: 1.55–1.75), and acute kidney injury (OR = 1.39, 95% CI: 1.20–1.61). Conclusion: P-CABs have reshaped the prescription landscape of gastric acid suppressants. Further longitudinal cohort studies are required to evaluate long-term safety in routine clinical practice.https://doi.org/10.1177/17562848251356406
spellingShingle Min Jeong Je
Jeong Min Go
Shin Yeong Kim
Min-Gul Kim
Hankil Lee
Ha-Lim Jeon
Jae Hyun Kim
Prescription trends of gastric acid suppressants and association with potential adverse events in Korea: a real-world cross-sectional study
Therapeutic Advances in Gastroenterology
title Prescription trends of gastric acid suppressants and association with potential adverse events in Korea: a real-world cross-sectional study
title_full Prescription trends of gastric acid suppressants and association with potential adverse events in Korea: a real-world cross-sectional study
title_fullStr Prescription trends of gastric acid suppressants and association with potential adverse events in Korea: a real-world cross-sectional study
title_full_unstemmed Prescription trends of gastric acid suppressants and association with potential adverse events in Korea: a real-world cross-sectional study
title_short Prescription trends of gastric acid suppressants and association with potential adverse events in Korea: a real-world cross-sectional study
title_sort prescription trends of gastric acid suppressants and association with potential adverse events in korea a real world cross sectional study
url https://doi.org/10.1177/17562848251356406
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