Half-dose rabeprazole has an equal efficacy to standard-dose rabeprazole on endoscopic submucosal dissection-induced ulcer.
BACKGROUND
Although endoscopic submucosal dissection (ESD)-induced ulcers heal faster and recur less often than non-iatrogenic gastric ulcers, the optimal dosage and duration of proton pump inhibitor treatment for ESD-induced ulcers remain unclear.


OBJECTIVE
To evaluate the efficacy of half-dose rabeprazole on endoscopic submucosal dissection-induced ulcer compared with standard dose rabeprazole.


METHODS
The study was a prospective randomized controlled double-blind trial at a single tertiary hospital. A total of 80 patients who underwent ESD for gastric neoplasia were enrolled. Of these patients, 10 were not followed to completion. Final analysis included the remaining 70 patients. Rabeprazole 20 or 10 mg, depending on randomization, was given orally for 4 weeks after ESD.


RESULTS
Of the 70 patients, 45 (64 %) were men, and the median age was 65.2 ± 9.7 years. The mean ESD-induced ulcer area was 673 mm(2). No significant differences in ulcer area reduction ratio (p = 0.49) or ulcer-related symptoms (p = 0.91) were observed between the two groups at 4 weeks after ESD.


CONCLUSIONS
For ESD-induced ulcers, treatment with 10 mg of rabeprazole daily produces a similar outcome as 20 mg of rabeprazole with regard to healing efficacy and symptom resolution.
Division of Gastroenterology and Hepatology, Department of Internal Medicine and Institute of Lifelong Health, Wonju College of Medicine, Yonsei University, 162, Ilsan-dong, Gangwon-do, Wonju 220-701, Korea.
Hong Jun
HJ
Park
Hyun-Soo
HS
Kim
Bo Ra
BR
Kim
So Yeon
SY
Park
Jin Heon
JH
Hong
Ki Won
KW
Jo
Jae Woo
JW
Kim
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000008:administration & dosage*; D000368:Aged; D004311:Double-Blind Method; D005260:Female; D005773:Gastroscopy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000008:administration & dosage*; D064750:Rabeprazole; D013270:Stomach / Q000473:pathology; D013274:Stomach Neoplasms / Q000601:surgery*; D013276:Stomach Ulcer / Q000209:etiology* / Q000473:pathology
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D054328:Proton Pump Inhibitors; D064750:Rabeprazole