Sebela Pharmaceuticals Submits NDA for Tegoprazan, Novel P-CAB Showing Superior GERD Treatment Efficacy
Key Insights
Braintree Laboratories (search) submitted an NDA to the FDA on January 9, 2026, for tegoprazan, a novel potassium-competitive acid blocker (P-CAB) seeking approval for three GERD (search) indications.
Phase 3 TRIUMpH program data from over 2,000 US patients demonstrated tegoprazan's statistical superiority over proton pump inhibitors in healing erosive esophagitis (search) across all severity grades.
The drug showed rapid acid control within 45 minutes and superior sustained healing compared to lansoprazole, addressing unmet needs for 35-54% of GERD (search) patients inadequately controlled by current therapies.
Braintree Laboratories (search), a part of Sebela Pharmaceuticals (search), has submitted a New Drug Application (NDA) to the US Food and Drug Administration (FDA) for tegoprazan, a novel potassium-competitive acid blocker (P-CAB), marking a potential breakthrough in gastroesophageal reflux disease (search) (GERD (search)) treatment. The submission, filed on January 9, 2026, seeks simultaneous approval for three indications: treatment of heartburn associated with non-erosive reflux disease (search) (NERD (search)), healing of erosive esophagitis (search) (EE), and maintenance of EE healing.
Clinical Program Demonstrates Superior Efficacy
The NDA is supported by robust data from the pivotal Phase 3 TRIUMpH clinical program, which enrolled over 2,000 US patients and demonstrated tegoprazan's clinical superiority over proton pump inhibitors (PPIs) across multiple endpoints. The program comprises two large, multicenter, double-blind studies specifically designed to evaluate tegoprazan's safety and efficacy in both EE and NERD (search) patient populations.
In the Phase 3 NERD (search) study (n=800), tegoprazan demonstrated statistically superior results compared to placebo for the percentage of 24-hour heartburn-free days (P <.0001 and P = .0006 for tegoprazan 100 mg and 50 mg, respectively). The drug also showed superiority for percentage of days without overnight heartburn and percentage of days without regurgitation over the 4-week treatment period.
The Phase 3 EE study (n=1,250, including 463 patients with LA Grade C and D esophagitis) evaluated tegoprazan 100 mg versus lansoprazole 30 mg. Results showed tegoprazan demonstrated statistically superior healing compared to lansoprazole at both 2 and 8 weeks across all grades of EE (LA Grades A-D: P <.0001 and P = .0083 for tegoprazan 100 mg at weeks 2 and 8, respectively). In patients with severe disease (LA Grades C and D), the superiority was even more pronounced (P <.0001 and P = .0002 for tegoprazan 100 mg at weeks 2 and 8, respectively).
Sustained Maintenance Benefits
In the 24-week maintenance phase, tegoprazan showed superior sustained healing compared to PPI therapy in all patients (P <.0001 and P = .0145 for tegoprazan 100 mg and 50 mg, respectively). The drug also demonstrated superior healing and heartburn relief in patients with severe disease, addressing a critical unmet need in this challenging patient population.
Addressing Significant Unmet Medical Need
GERD (search) affects approximately 65 million Americans, representing a substantial healthcare burden with significant impact on patients' quality of life. Despite the availability of acid suppression therapies, 35% to 54% of patients continue to suffer from inadequate symptom control with current treatments. Patients with more severe erosive esophagitis (search) and those with NERD (search) are particularly likely to experience incomplete response with standard PPI treatment.
"GERD (search) affects approximately 65 million Americans, and despite the availability of acid suppression therapies, 35% to 54% of patients continue to suffer from inadequate symptom control," said Alan Cooke, President and CEO of Sebela Pharmaceuticals (search). "Tegoprazan's results from its Phase 3 TRIUMpH program demonstrate superiority to a PPI in sustained healing of EE in even the most severe cases, and clinically meaningful relief of 24-hour heartburn, overnight heartburn and regurgitation in NERD (search) patients."
Novel Mechanism of Action
Tegoprazan is a novel, once-daily oral medication in the P-CAB class that works by reversibly binding to the gastric proton pump (search) in a potassium-competitive manner, providing fast and potent acid suppression independent of meals. In Phase 1 pharmacodynamic studies, tegoprazan demonstrated rapid acid control (pH>4) within 45 minutes, offering more rapid onset and sustained gastric pH control compared to proton pump inhibitors.
"The emergence of potassium-competitive acid blockers represents an important advance in acid suppression therapy, offering more rapid onset and sustained gastric pH control compared to proton pump inhibitors," commented Philip O. Katz, MD, Professor of Medicine at Weill Cornell Medicine. "The TRIUMpH program data are particularly noteworthy in demonstrating tegoprazan's potential to provide control of both heartburn and regurgitation in patients with NERD (search) as well as improved healing rates in patients with severe erosive esophagitis (search)."
Safety Profile
Across both pivotal studies, individual treatment-emergent adverse events occurred at a rate of less than 3% and were generally mild and transient. The overall rate of serious treatment-emergent adverse events in each study was less than 2% and similar between tegoprazan and comparator groups. Mean serum gastrin levels for tegoprazan and lansoprazole remained within the normal range (0-180 pg/ml) throughout the treatment periods.
Global Market Presence and Future Outlook
Tegoprazan has already received marketing authorization in 21 countries worldwide. If approved by the FDA, tegoprazan would be indicated in the US for the treatment of heartburn in NERD (search) and for the healing and maintenance of healing of EE in adults. The company expects to bring this treatment option to patients and healthcare providers in January 2027, pending FDA approval.
Once approved, tegoprazan will be the first P-CAB to demonstrate superiority in EE healing across all severity grades (LA Grades A-D) and at all time points versus a proton pump inhibitor. Sebela plans to present full results from the TRIUMpH program at upcoming medical meetings in 2026 and submit for publication in respected peer-reviewed journals.