Takahashi K, Sato Y, Kohisa J, Watanabe J, Sato H, Mizuno K, Hashimoto S, Terai S. Vonoprazan 20 mg vs lansoprazole 30 mg for endoscopic submucosal dissection-induced gastric ulcers. World J Gastrointest Endosc 2016; 8(19): 716-722 [PMID: 27909552 DOI: 10.4253/wjge.v8.i19.716]
Corresponding Author of This Article
Kazuya Takahashi, MD, PhD, Division of Gastroenterology and Hepatology, Niigata University Medical and Dental Hospital, 757-1, Asahimachidori, Chuo-ku, Niigata-city, Niigata 951-8510, Japan. kazuya911@med.niigata-u.ac.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Randomized Controlled Trial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Kazuya Takahashi, Yuichi Sato, Department of Endoscopy, Niigata University Medical and Dental Hospital, Niigata 951-8510, Japan
Kazuya Takahashi, Junji Kohisa, Division of Gastroenterology and Hepatology, Sado General Hospital, Niigata 952-1209, Japan
Kazuya Takahashi, Hiroki Sato, Kenichi Mizuno, Satoru Hashimoto, Shuji Terai, Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan
Jun Watanabe, Division of Gastroenterology and Hepatology, Nagaoka Red Cross Hospital, Niigata 940-0095, Japan
Author contributions: Takahashi K designed this study, collected and analyzed the data and drafted the manuscript; Terai S gave final approval of the version to be published; Sato Y revised the manuscript; Kohisa J, Watanabe J, Sato H, Mizuno K and Hashimoto S took part in this study as endoscopic operators or assistants.
Institutional review board statement: The study protocol was approved by the Sado General Hospital Institutional Ethics Committee.
Clinical trial registration statement: This study is registered at UMIN clinical Trial Registry. The registration identification number is UMIN000022006.
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: None declared.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kazuya Takahashi, MD, PhD, Division of Gastroenterology and Hepatology, Niigata University Medical and Dental Hospital, 757-1, Asahimachidori, Chuo-ku, Niigata-city, Niigata 951-8510, Japan. kazuya911@med.niigata-u.ac.jp
Telephone: +81-25-2232207 Fax: +81-25-2230776
Received: May 29, 2016 Peer-review started: May 30, 2016 First decision: July 20, 2016 Revised: August 1, 2016 Accepted: September 13, 2016 Article in press: September 18, 2016 Published online: November 16, 2016 Processing time: 168 Days and 16 Hours
Abstract
AIM
To compare the healing effects of vonoprazan and lansoprazole on gastric ulcers induced by endoscopic submucosal dissection (ESD).
METHODS
Data were obtained from a total of 26 patients. Fourteen patients were randomized to the vonoprazan group and 12 were randomized to the lansoprazole group. Patients were administered either 20 mg vonoprazan or 30 mg lansoprazole per day after ESD. Endoscopic images just after ESD, on day 8, and on day 28 were used for the evaluation of the shrinking rate of ESD ulcers. The shrinking rates and the incidence of delayed bleeding were compared between the 2 groups.
RESULTS
The shrinking rates of ESD ulcers on day 8 [vonoprazan group: 61.8% (range: 24.0%-91.1%), lansoprazole group: 71.3% (range: 25.2%-88.6%)] and on day 28 [vonoprazan group: 95.3% (range: 76.2%-100%), lansoprazole group: 97.2% (range: 81.1%-99.8%)] were not statistically different between the 2 groups. On day 28, most of the ulcers in both groups healed to more than 90%, whereas 3 of 14 (21.4%) in the vonoprazan group and 1 of 12 (8.3%) in the lansoprazole group had delayed ulcer healing, which was not statistically different (P = 0.356). The frequency of delayed bleeding was 0 in the both groups. Taken together, there were no significant differences between the two drug groups.
CONCLUSION
Our study indicates that vonoprazan is potent for the management of ESD ulcers although lansoprazole is also sufficient and cost-effective.
Core tip: Our study highlights the comparison of two drugs (vonoprazan and lansoprazole) for the treatment of gastric ulcers induced by endoscopic submucosal dissection (ESD). There were no significant differences between the two drugs with regard to ulcer shrinkage and delayed bleeding. Our study indicated vonoprazan was potent for the management of ESD ulcers although lansoprazole was also sufficient and cost-effective.
