Acid-related diseases: shortcomings of current therapy and emerging perspectives. Results of the study “STEP”

Aim. To study the management practices of patients with acid-related gastrointestinal (GI) disorders and the factors influencing the choice of antisecretory therapy. Materials and methods. A nationwide online survey was conducted among 500 physicians (150 gastroenterologists and 350 general practitioners) from 185 cities across Russia. The questionnaire included items on the structure of acid-related diseases (ARD), diagnostic approaches, therapy patterns, challenges associated with proton pump inhibitors (PPIs), and attitudes toward potassium-competitive acid blockers (P-CABs). Results. ARDs represent a substantial share of outpatient visits: 20-40% of patients in general practice and up to 50% in gastroenterology. The most frequent diagnoses were chronic gastritis, non-erosive gastroesophageal reflux disease (NERD), and Helicobacter pylori associated gastric disorders. Diagnosis of gastroesophageal reflux disease (GERD) is primarily based on clinical and endoscopic assessment: 96% of physicians perform esophagogastroduodenoscopy, while pH monitoring and pH impedance testing are used by only 7-11%. PPIs remain the cornerstone of GERD therapy (up to 82% of prescriptions). However, several limitations have been identified with their use: 54% of physicians note the risk of adverse effects with long-term therapy, 50% emphasize the need for administration before meals, 30% encounter nocturnal acid breakthrough, and 38% report a delayed onset of action. According to physicians, the key criteria when choosing an antisecretory agent include 24-hour efficacy, absence of nocturnal acid breakthrough, rapid onset of action, and minimal drug interactions. The introduction of new drug tegoprazan to the Russian market helps address these unmet needs due to its meal-independent rapid action, sustained 24-hour effect, and protection against nocturnal acid breakthrough. 71% of physicians consider Tegoprex® a potential alternative to PPIs in most clinical cases. Conclusions. Although PPIs remain dominant in ARD therapy, their limitations create a clear demand for alternatives. Tegoprex® demonstrates high clinical potential and is perceived by specialists as a promising replacement for PPIs.

GERD, acid-related diseases, PPIs, PCABs, tegoprazan, Tegoprex®, antisecretory therapy

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