Abstract
BackgroundVonoprazan is more potent and longer acting than traditional proton pump inhibitor. Although vonoprazan is expected to be superior to proton pump inhibitor, its efficacy in the treatment of gastric ulcers following endoscopic submucosal dissection (ESD) is not fully understood. The aim of this study was to evaluate the effectiveness of vonoprazan in artificial ulcer healing following ESD.MethodsPatients with gastric tumors were randomly assigned to the vonoprazan group (group V) or lansoprazole group (group L) after ESD. Patients received intravenous lansoprazole (30 mg) twice on the day of ESD. Thereafter, patients were treated with vonoprazan (20 mg/day) in group V or lansoprazole (30 mg/day) in group L. Esophagogastroduodenoscopy was performed 4 and 8 weeks after the ESD.ResultsA total of 168 patients were analyzed. The 4-week healing rate for artificial ulcer was not significantly higher in group V versus group L (17/85, 20.0% vs. 14/83, 16.9%, respectively). In addition, there were no significant differences between the 4-week shrinkage rates between the two groups. Postoperative bleeding occurred in none of the patients in group V and three in group L. One patient in group V presented delayed perforation 2 days after ESD.ConclusionsVonoprazan might not be superior to lansoprazole in the healing of artificial gastric ulcer after ESD.Trial registration: University hospital Medical Information Network (registration number: UMIN000016642), Registered 27 February 2015, https://www.umin.ac.jp/ctr/index-j.htm.
Highlights
Vonoprazan is more potent and longer acting than traditional proton pump inhibitor
Following endoscopic submucosal dissection (ESD), patients were randomly assigned to the vonoprazan group or the lansoprazole group through the minimization method using Kullback–Leibler divergence [9]
Of the 263 patients who underwent gastric ESD from April 2015 to December 2017, 182 patients (90 in group V and 92 in group L) were eligible to participate in the study
Summary
Vonoprazan is more potent and longer acting than traditional proton pump inhibitor. Vonoprazan is expected to be superior to proton pump inhibitor, its efficacy in the treatment of gastric ulcers following endoscopic submucosal dissection (ESD) is not fully understood. The aim of this study was to evaluate the effectiveness of vonoprazan in artificial ulcer healing following ESD. Vonoprazan is a novel suppressant of gastric acid secretion and an active potassium-competitive acid blocker (P-CAB) [6]. Vonoprazan is more potent with a more long-lasting effect than that of PPIs [7, 8]. Vonoprazan is expected to be superior to PPIs, and lead to earlier healing of ESD-induced gastric ulcers versus conventional PPI-based therapy. In this study, we aimed to evaluate the effectiveness of vonoprazan in healing artificial ulcers after ESD
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