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- Title
Vonoprazan prevents bleeding from endoscopic submucosal dissection-induced gastric ulcers.
- Authors
Kagawa, T.; Iwamuro, M.; Ishikawa, S.; Ishida, M.; Kuraoka, S.; Sasaki, K.; Sakakihara, I.; Izumikawa, K.; Yamamoto, K.; Takahashi, S.; Tanaka, S.; Matsuura, M.; Hasui, T.; Wato, M.; Inaba, T.
- Abstract
Background Vonoprazan, a potassium-competitive acid blocker, is expected to improve the healing of endoscopic submucosal dissection ( ESD)-induced gastric ulcers compared with proton pump inhibitors ( PPIs). Aim To compare the healing status of ESD-induced gastric ulcers and the incidence of post- ESD bleeding between subjects treated with vonoprazan for 5 weeks and those treated with PPIs for 8 weeks. Methods Patients in the vonoprazan group ( n = 75) were prospectively enrolled, whereas patients in the PPI group ( n = 150) were selected for a 2:1 matched historical control cohort according to baseline characteristics including gastric ulcer size immediately following ESD, age, sex and status of Helicobacter pylori infection. Two controls per case of vonoprazan-treated group were matched with a margin of 20% in terms of ulcer size and a margin of 5 years in terms of their age. Results Although a higher number of completely healed ulcers was observed in the PPI group (95/150, 63.3%) than that in the vonoprazan group (14/75, 18.7%; P < 0.001), the ulcer size reduction rates, which were 96.0 ± 6.7% in the vonoprazan group and 94.7 ± 11.6% in the PPI group, were not significantly different ( P = 0.373). The post- ESD bleeding incidence in the vonoprazan group (1/75, 1.3%) was less than that in the PPI group (15/150, 10.0%; P = 0.01). The factors affecting post- ESD bleeding incidence were the type of acid secretion inhibitor ( P = 0.016) and use of an anti-thrombotic agent ( P = 0.014). Conclusion Vonoprazan significantly reduced post-endoscopic submucosal dissection bleeding compared with PPIs.
- Subjects
ULCERS; PROTON pump inhibitors; HELICOBACTER pylori infections; OMEPRAZOLE; LANSOPRAZOLE
- Publication
Alimentary Pharmacology & Therapeutics, 2016, Vol 44, Issue 6, p583
- ISSN
0269-2813
- Publication type
Article
- DOI
10.1111/apt.13747