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

Daisuke Kawai, Ryuta Takenaka, Mikako Ishiguro, Shotaro Okanoue, Tatsuhiro Gotoda, Yoshiyasu Kono, Koji Takemoto, Hirofumi Tsugeno, Shigeatsu Fujiki

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Article number236
JournalBMC Gastroenterology
Volume21
Issue number1
DOIs
Publication statusPublished - Dec 2021
Externally publishedYes

Keywords

  • Endoscopic submucosal dissection
  • Gastric neoplasm
  • Lansoprazole
  • Postoperative bleeding
  • Vonoprazan

ASJC Scopus subject areas

  • Gastroenterology

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