title: Efficacy of treatment with rebamipide for endoscopic submucosal dissection-induced ulcers.
abstract: OBJECTIVE
  To prospectively compare the healing rates of endoscopic submucosal dissection (ESD)-induced ulcers treated with either a proton-pump inhibitor (PPI) or rebamipide.
  
  
  METHODS
  We examined 90 patients with early gastric cancer who had undergone ESD. All patients were administered an intravenous infusion of the PPI lansoprazole (20 mg) every 12 h for 2 d, followed by oral administration of lansoprazole (30 mg/d, 5 d). After 7-d treatment, the patients were randomly assigned to 2 groups and received either lansoprazole (30 mg/d orally, n = 45; PPI group) or rebamipide (300 mg orally, three times a day; n = 45; rebamipide group). At 4 and 8 wk after ESD, the ulcer outcomes in the 2 groups were compared.
  
  
  RESULTS
  No significant differences were noted in patient age, underlying disease, tumor location, Helicobacter pylori infection rate, or ESD-induced ulcer size between the 2 groups. At both 4 and 8 wk, the healing rates of ESD-induced ulcers were similar in the PPI-treated and the rebamipide-treated patients (4 wk: PPI, 27.2%; rebamipide, 33.3%; P = 0.5341; 8 wk: PPI, 90.9%; rebamipide, 93.3%; P = 0.6710). At 8 wk, the rates of granulation lesions following ulcer healing were significantly higher in the PPI-treated group (13.6%) than in the rebamipide-treated group (0.0%; P = 0.0103). Ulcer-related symptoms were similar in the 2 treatment groups at 8 wk. The medication cost of 8-wk treatment with the PPI was 10945 yen vs 4889 yen for rebamipide. No ulcer bleeding or complications due to the drugs were observed in either treatment group.
  
  
  CONCLUSIONS
  The healing rate of ESD-induced ulcers was similar with rebamipide or PPI treatment; however, rebamipide treatment is more cost-effective and prevents granulation lesions following ulcer healing.
authors.affiliation: Masaki Takayama, Shigenaga Matsui, Masanori Kawasaki, Yutaka Asakuma, Toshiharu Sakurai, Hiroshi Kashida, Masatoshi Kudo, Department of Gastroenterology and Hepatology, Kinki University, Osaka 589-8511, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Takayama
authors.forename: Shigenaga
authors.initials: S
authors.lastname: Matsui
authors.forename: Masanori
authors.initials: M
authors.lastname: Kawasaki
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Asakuma
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Sakurai
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kashida
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kudo
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery; D000368:Aged; D000409:Alanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D004210:Dissection / Q000009:adverse effects; D005260:Female; D005773:Gastroscopy / Q000009:adverse effects; D006801:Humans; D007049:Iatrogenic Disease; D064747:Lansoprazole / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000188:drug therapy* / Q000209:etiology; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D015363:Quinolones / Q000627:therapeutic use*; D013274:Stomach Neoplasms / Q000601:surgery
chemical_list: D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors; D015363:Quinolones; D064747:Lansoprazole; C052785:rebamipide; D000409:Alanine
keywords: Early gastric cancer; Endoscopic submucosal dissection; Gastric ulcer; Proton-pump inhibitor; Rebamipide
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