The effect of short-term proton pump inhibitor plus anti-ulcer drug on the healing of endoscopic submucosal dissection-derived artificial ulcer: a randomized controlled trial.
OBJECTIVE
Artificial ulcers remain a major complication after Endoscopic submucosal dissection (ESD). The development of more effective treatment regimen for this ulcer is required than the use of proton pump inhibitor (PPI) alone.


METHODS
Patients with ESD-derived artificial ulcers were randomly assigned to two groups: a group of patients who received rabeprazole 20 mg daily for 8 weeks (PPI group) and a group of patients who received a combination of rebamipide 300 mg daily for 8 weeks and rabeprazole 20 mg dairy for the first 4 weeks (reb+PPI group). The area reduction ratio and healing status of ulcers were evaluated endoscopically on postoperative 7, 28 and 56 days.


RESULTS
The overall ulcer area reduction ratio was higher in the reb+PPI group than in the PPI group, especially at an early stage. The ratio of progression to the H1 stage in the reb+PPI group was significantly higher than that in the PPI group, especially at an early stage.


CONCLUSIONS
Treatment with 8 weeks of rebamipide plus the first 4 weeks of PPI demonstrated a reduction ratio of artificial ulcers superior to that with 8 weeks of PPI mono-therapy. This combination treatment is, therefore, one of the candidate treatment strategies against ESD-derived artificial ulcers.
Masakatsu
M
Nakamura
Tomomitsu
T
Tahara
Hisakazu
H
Shiroeda
Kazuhiro
K
Matsunaga
Toshimi
T
Otsuka
Joh
J
Yonemura
Tomoyuki
T
Shibata
Tomiyasu
T
Arisawa
D000368:Aged; D000409:Alanine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D000897:Anti-Ulcer Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004210:Dissection / Q000009:adverse effects*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D005773:Gastroscopy / Q000009:adverse effects*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D015363:Quinolones / Q000008:administration & dosage* / Q000009:adverse effects; D064750:Rabeprazole / Q000008:administration & dosage* / Q000009:adverse effects; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D013276:Stomach Ulcer / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects*
D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors; D015363:Quinolones; D064750:Rabeprazole; C052785:rebamipide; D000409:Alanine