scholarly journals Vonoprazan Versus Lansoprazole in the Treatment of Artificial Gastric Ulcers After Endoscopic Submucosal Dissection: a Randomized Controlled Trial

2020 ◽  
Author(s):  
Daisuke Kawai ◽  
Ryuta Takenaka ◽  
Mikako Ishiguro ◽  
Shotaro Okanoue ◽  
Tatsuhiro Gotoda ◽  
...  
Keyword(s):  
Proton Pump Inhibitor ◽  
Endoscopic Submucosal Dissection ◽  
Proton Pump ◽  
Medical Information ◽  
Controlled Trial ◽  
Postoperative Bleeding ◽  
University Hospital ◽  
Gastric Ulcers ◽  
Group V ◽  
Submucosal Dissection

Abstract Background: Vonoprazan 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. Methods: Patients with gastric tumors were randomly assigned to the vonoprazan group (group V) or lansoprazole group (group L) after ESD. Patients received intravenous lansoprazole (30mg) 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. Results: A 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. Conclusions: Vonoprazan 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

scholarly journals Vonoprazan versus lansoprazole in the treatment of artificial gastric ulcers after endoscopic submucossal dissection: a randomized, open-label trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daisuke Kawai ◽  
Ryuta Takenaka ◽  
Mikako Ishiguro ◽  
Shotaro Okanoue ◽  
Tatsuhiro Gotoda ◽  
...  
Keyword(s):  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Medical Information ◽  
Postoperative Bleeding ◽  
University Hospital ◽  
Gastric Ulcers ◽  
Open Label ◽  
Group V ◽  
Registration Number ◽  
Delayed Perforation

Abstract Background Vonoprazan 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. Methods Patients 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. Results A 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. Conclusions Vonoprazan 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.

scholarly journals A prospective randomized trial of a potassium competitive acid blocker vs proton pump inhibitors on the effect of ulcer healing after endoscopic submucosal dissection of gastric neoplasia

2019 ◽  
Vol 47 (4) ◽  
pp. 1441-1452 ◽  
Author(s):  
Hiroyuki Komori ◽  
Hiroya Ueyama ◽  
Akihito Nagahara ◽  
Yoichi Akazawa ◽  
Tsutomu Takeda ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Healing Process ◽  
Reduction Rate ◽  
Gastric Ulcers ◽  
Group V ◽  
Ulcer Area ◽  
Submucosal Dissection ◽  
Gastric Neoplasia

Background/Aims Vonoprazan is a new a potassium-competitive acid blocker (P-CAB) that was recently developed in Japan. However, vonoprazan’s efficacy in healing gastric ulcers after endoscopic submucosal dissection (ESD) remains controversial. This study aimed to compare the efficacy of P-CABs and proton pump inhibitors (PPIs) in healing post-ESD ulcers. Materials and Methods This prospective randomized controlled trial (UMIN000017386) enrolled 40 patients with gastric neoplasia, who underwent ESD at our hospital from April 2015 to January 2016. Before ESD, patients were randomly divided into the following two groups: group V, vonoprazan 20 mg/day; or group R, rabeprazole 10 mg/day. Medications were taken 1 day before to 4 weeks after ESD. The ESD-induced artificial ulcer size was measured just after ESD and 4 weeks after ESD to calculate the reduction rate as follows: (ulcer area 4 weeks after ESD)/(ulcer area just after ESD) × 100. Results Eighteen patients in group V and 15 patients in group R were analyzed. The mean reduction rate was significantly different in groups V and R (93.3% vs 96.6%, respectively). Post-ESD bleeding was observed in two patients in group R and drug-induced hepatic injury in one patient in group R. Conclusion Rabeprazole facilitated the healing process post-ESD.

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