title: Vonoprazan prevents bleeding from endoscopic submucosal dissection-induced gastric ulcers.
abstract: Vonoprazan, a potassium-competitive acid blocker, is expected to improve the healing of endoscopic submucosal dissection (ESD)-induced gastric ulcers compared with proton pump inhibitors (PPIs).
  
  
  
  To compare the healing status of ESD-induced gastric ulcers and the incidence of post-ESD bleeding between subjects treated with vonoprazan for 5 weeks and those treated with PPIs for 8 weeks.
  
  
  
  Patients in the vonoprazan group (n = 75) were prospectively enrolled, whereas patients in the PPI group (n = 150) were selected for a 2:1 matched historical control cohort according to baseline characteristics including gastric ulcer size immediately following ESD, age, sex and status of Helicobacter pylori infection. Two controls per case of vonoprazan-treated group were matched with a margin of 20% in terms of ulcer size and a margin of 5 years in terms of their age.
  
  
  
  Although a higher number of completely healed ulcers was observed in the PPI group (95/150, 63.3%) than that in the vonoprazan group (14/75, 18.7%; P < 0.001), the ulcer size reduction rates, which were 96.0 ± 6.7% in the vonoprazan group and 94.7 ± 11.6% in the PPI group, were not significantly different (P = 0.373). The post-ESD bleeding incidence in the vonoprazan group (1/75, 1.3%) was less than that in the PPI group (15/150, 10.0%; P = 0.01). The factors affecting post-ESD bleeding incidence were the type of acid secretion inhibitor (P = 0.016) and use of an anti-thrombotic agent (P = 0.014).
  
  
  
  Vonoprazan significantly reduced post-endoscopic submucosal dissection bleeding compared with PPIs.
authors.affiliation: Department of Gastroenterology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Kagawa
authors.affiliation: Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.|Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Iwamuro
authors.affiliation: Department of Gastroenterology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Ishikawa
authors.affiliation: Department of Gastroenterology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Ishida
authors.affiliation: Department of Gastroenterology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Kuraoka
authors.affiliation: Department of Gastroenterology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Sasaki
authors.affiliation: Department of Gastroenterology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
authors.forename: I
authors.initials: I
authors.lastname: Sakakihara
authors.affiliation: Department of Gastroenterology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Izumikawa
authors.affiliation: Department of Gastroenterology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Yamamoto
authors.affiliation: Department of Gastroenterology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Department of Gastroenterology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: Department of Gastroenterology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Matsuura
authors.affiliation: Department of Gastroenterology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Hasui
authors.affiliation: Department of Gastroenterology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Wato
authors.affiliation: Department of Gastroenterology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Inaba
mesh_terms: D000236:Adenoma / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D000069916:Endoscopic Mucosal Resection / Q000009:adverse effects*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy*; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D011758:Pyrroles / Q000627:therapeutic use*; D064750:Rabeprazole / Q000627:therapeutic use; D013274:Stomach Neoplasms / Q000601:surgery; D013276:Stomach Ulcer / Q000188:drug therapy* / Q000209:etiology*; D013449:Sulfonamides / Q000627:therapeutic use*; D014945:Wound Healing / Q000187:drug effects
chemical_list: C552956:1-(5-(2-fluorophenyl)-1-(pyridin-3-ylsulfonyl)-1H-pyrrol-3-yl)-N-methylmethanamine; D054328:Proton Pump Inhibitors; D011758:Pyrroles; D013449:Sulfonamides; D064750:Rabeprazole