Recently, the "China Expert Consensus on Rational Use of Acid Suppressants in Elderly Patients (2026 Edition)" (hereinafter referred to as the "Consensus"), initiated by the Geriatrics Branch of the Chinese Medical Association, was officially released. With the accelerating aging population in China, the co-occurrence of digestive disorders and cardiovascular/metabolic diseases among elderly patients has become widespread. The release of the Consensus provides the latest evidence-based guidance for the standardized and safe clinical use of acid suppressants. Among them, Anagliptide, a Class 1 chemically innovative drug independently developed by Xuanzhu Biotech, has received explicit priority recommendation in the Consensus due to its unique metabolic characteristics.

There is a significant demand for long-term acid suppression therapy among elderly patients.

The Consensus explicitly states that elderly patients often require long-term use of acid-suppressing agents under the following two circumstances:

Maintenance therapy for gastroesophageal reflux disease (GERD): GERD in elderly patients is chronic and recurrent, often requiring proton pump inhibitors (PPIs) for maintenance therapy (Consensus Opinion 6).

Prevention of gastrointestinal injury caused by high-risk drugs: The gastric mucosal defense mechanisms in elderly individuals are compromised, and long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), glucocorticoids, antiplatelet agents, and novel oral anticoagulants significantly increases the risk of gastrointestinal injury or even bleeding. The Consensus recommends that patients aged ≥70 years should concurrently take proton pump inhibitors (PPIs) for prophylaxis (Consensus Opinion 8).

How to select acid-suppressing agents for long-term use? The Consensus emphasizes that drug interactions require careful consideration.

For the long-term use of acid-suppressing agents, safety remains the primary consideration. Regarding the newer-generation potassium ion competitive acid blockers (P-CABs), the Consensus objectively states that they demonstrate good short-term safety profiles; however, due to impaired hepatic and renal function in elderly patients, "caution should be exercised regarding long-term use of P-CABs in this population" (Consensus Opinion 18). Therefore, proton pump inhibitors (PPIs) remain the preferred first-line therapy for long-term maintenance therapy in elderly patients.

However, elderly patients often require concurrent use of multiple medications. Traditional acid-suppressing agents primarily rely on hepatic CYP450 enzyme-mediated metabolism, which significantly increases the risk of drug-drug interactions (DDIs). To address this challenge, the Consensus provides a clear solution in "Consensus Opinion 23":

From a metabolic pathway perspective, pantoprazole undergoes Phase II metabolism, whereas rabeprazole and ananilazole undergo non-enzymatic metabolism. These agents may be prioritized for use when acid suppression therapy is required, particularly in cases of long-term administration.

Anirazole: Unique non-enzymatic + multi-enzyme metabolism, ensuring greater safety with long-term use

As China's first novel proton pump inhibitor (PPI) with fully independent intellectual property rights, Xuanzhu Bio's antrazole aligns with the Consensus' expectations for high-quality long-term acid suppression therapy in elderly patients. As authoritatively recommended by the Consensus, antrazole exhibits a unique non-enzymatic plus multi-enzyme metabolic pathway and demonstrates minimal dependence on the CYP450 enzyme system. In elderly patients with comorbid cardiovascular, cerebrovascular, or osteoarticular diseases who require long-term concomitant use of high-risk medications such as clopidogrel or NSAIDs, antrazole may reduce the risk of drug-drug interactions (DDIs).

Through original innovation, benefiting millions of individuals with comorbidities

According to large-scale epidemiological systematic reviews both domestically and internationally, the prevalence of polypharmacy among

individuals aged 65 and above worldwide ranges from 40% to 56%, resulting in a high proportion of elderly patients in communities experiencing "multiple medication use" (taking five or more drugs simultaneously), reaching as high as 37%. More alarmingly, a nationwide, 13-year real-world drug utilization study revealed that nearly half (approximately 50%) of elderly patients using proton pump inhibitors (PPIs) were concurrently taking nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, oral anticoagulants, or antiplatelet agents. Facing such a vast and prevalent population, Xuanzhu Biotech has consistently undertaken the mission of "addressing unmet clinical needs." We will actively adhere to the guidelines outlined in the 2026 edition of the Consensus, leveraging the unique non-enzymatic plus multi-enzyme metabolic advantages of antrazole to provide superior solutions for millions of patients with polypharmacy.

[Compliance and Disclaimer]

1. This article is intended solely for academic exchange and reference purposes by healthcare professionals (HCP) and shall not be construed as any prescription recommendation or medical diagnostic advice.

2. Please strictly adhere to the latest version of the drug package insert approved by the National Medical Products Administration (NMPA).

3. The general public and patients should use medications appropriately under the guidance of a qualified physician or pharmacist, and must not self-administer drugs or alter treatment regimens without medical advice.

[1] A systematic review of the polypharmacy rate among elderly residents in communities and its associated factors. China General Practice. 2021.

[2] Proton-pump inhibitors among adults: a nationwide drug-utilization study. Ther Adv Gastroenterol. 2018.

About Xuanzhu Biology:

Xuanzhu Biotech (Stock Code: 02575.HK) is an innovative pharmaceutical company rooted in China with a global vision, focusing on major disease areas such as digestive disorders, oncology, and non-alcoholic fatty liver disease. The company is dedicated to the research, development, production, and commercialization of Class 1 new drugs based on core proprietary technologies. It boasts a top-tier R&D team, with key members possessing extensive experience in new drug development. As a cutting-edge player in commercially viable innovative drugs driven by R&D and AI empowerment, the company has established a unique product pipeline that encompasses small-molecule chemical drugs, large-molecule biologics, antibody-drug conjugates, and more—a rarity in China. Guided by unmet clinical needs, the company strives to become a leading innovative pharmaceutical enterprise with comprehensive capabilities in independent R&D, production, and sales.