title: Effect of lansoprazole versus roxatidine on prevention of bleeding and promotion of ulcer healing after endoscopic submucosal dissection for superficial gastric neoplasia.
abstract: BACKGROUND
  Proton pump inhibitors have been reported to be more useful than histamine-2 receptor antagonists for the prevention of bleeding after endoscopic submucosal dissection (ESD) for superficial gastric neoplasia. The aim of this study was to assess the effects of the proton pump inhibitor lansoprazole and the histamine-2 receptor antagonist roxatidine for the prevention of bleeding and the promotion of ulcer healing after ESD and to compare the cost-effectiveness of these two drugs.
  
  
  METHODS
  The study subjects were 129 patients who underwent ESD for superficial gastric neoplasia. The patients were randomly assigned to the lansoprazole group (L group) or the roxatidine group (R group). Either drug was administered intravenously from the morning of the ESD day to the day after the ESD, followed by oral treatment for an additional 8 weeks. A second-look endoscopy was performed on the day after the ESD, and a repeat endoscopy was performed at 8 weeks after the ESD. The incidence of bleeding and the ulcer-healing rate at 8 weeks after the ESD were analyzed, as well as the total cost of treatment with these antisecretory agents.
  
  
  RESULTS
  Three patients in each group were excluded from the analysis, leaving 62 patients in L group and 61 in R group. Two of the 62 patients (3.2%) in L group and three of the 61 patients (4.9%) in R group showed bleeding after ESD ; there was no significant difference between the two groups (P = 0.68). The ulcer-healing rate was 93.5% (58/62) in L group and 93.4% (57/61) in R group (P = 1). The total cost of treatment with the antisecretory agent from the day of the ESD to day 56 after the ESD was Yen 13,212 for lansoprazole and Yen 5,841 for roxatidine.
  
  
  CONCLUSIONS
  Roxatidine appears to have high cost-effectiveness in the prevention of bleeding and in the promotion of ulcer healing after ESD for superficial gastric neoplasia.
authors.affiliation: Department of General Internal Medicine, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0495, Japan. imaedahi@yahoo.co.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Imaeda
authors.forename: Naoki
authors.initials: N
authors.lastname: Hosoe
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Suzuki
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Saito
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Ida
authors.forename: Rieko
authors.initials: R
authors.lastname: Nakamura
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Iwao
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Ogata
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Hibi
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000008:administration & dosage*; D000368:Aged; D000369:Aged, 80 and over; D000897:Anti-Ulcer Agents / Q000008:administration & dosage*; D003362:Cost-Benefit Analysis; D004210:Dissection; D005260:Female; D005753:Gastric Mucosa / Q000601:surgery; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D005773:Gastroscopy / Q000009:adverse effects*; D006801:Humans; D064747:Lansoprazole; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D010880:Piperidines / Q000008:administration & dosage*; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D013276:Stomach Ulcer / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D010880:Piperidines; D064747:Lansoprazole; C053742:roxatidine acetate