title: Vonoprazan is superior to proton pump inhibitors in healing artificial ulcers of the stomach post-endoscopic submucosal dissection: A propensity score-matching analysis.
abstract: OBJECTIVE
  Proton pump inhibitors (PPI) are effective at healing artificial ulcers after endoscopic submucosal dissection (ESD) for gastric neoplasms; however, the efficacy of vonoprazan is not completely understood. The aim of the present study was to determine the healing effect of vonoprazan on artificial ulcers post-gastric ESD relative to PPI.
  
  
  METHODS
  Thirty-five patients who underwent gastric ESD between April and November 2015 were treated with vonoprazan 20 mg/day for 4 weeks and subsequently underwent endoscopy for evaluation of ulcer size (V group). Ulcer contraction rate was determined by the following formula: ([ESD specimen size] - [ulcer size at 4 weeks after ESD])/(ESD specimen size) × 100%. We compared the results with those of a historical control group treated with esomeprazole 20 mg/day for 4 weeks after gastric ESD and subsequently measured their ulcer size (33 patients, E group) by propensity score-matching methods.
  
  
  RESULTS
  Sixty-two subjects were enrolled after propensity score-matching. Ulcer contraction rate at 4 weeks after ESD in the V group was significantly higher than that of the E group (97.7 ± 3.2% vs 94.5 ± 6.7%, respectively, P = 0.025). Number of subjects with a scar-stage ulcer (100% contraction rate) tended to be higher in the V group relative to the E group (32% [10 of 31] vs 13% [4 of 31], respectively, P = 0.070, McNemar's chi-squared test).
  
  
  CONCLUSIONS
  Vonoprazan has a faster post-gastric ESD artificial ulcer contraction rate than esomeprazole. Vonoprazan may supersede PPI in treating post-ESD artificial ulcers of the stomach.
authors: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan.|Clinical Research Center, Chiba University Hospital, Chiba, Japan.
authors: Daisuke
authors: D
authors: Maruoka
authors: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Makoto
authors: M
authors: Arai
authors: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Shingo
authors: S
authors: Kasamatsu
authors: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Hideaki
authors: H
authors: Ishigami
authors: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Takashi
authors: T
authors: Taida
authors: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Kenichiro
authors: K
authors: Okimoto
authors: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Keiko
authors: K
authors: Saito
authors: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Tomoaki
authors: T
authors: Matsumura
authors: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Tomoo
authors: T
authors: Nakagawa
authors: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Tatsuro
authors: T
authors: Katsuno
authors: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Osamu
authors: O
authors: Yokosuka
mesh_terms: D000368:Aged; D000069916:Endoscopic Mucosal Resection / Q000009:adverse effects*; D064098:Esomeprazole / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D005773:Gastroscopy; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D057216:Propensity Score; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D011758:Pyrroles / Q000627:therapeutic use*; D013274:Stomach Neoplasms / Q000601:surgery*; D013276:Stomach Ulcer / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D013449:Sulfonamides / Q000627:therapeutic use*; D016896:Treatment Outcome
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; D064098:Esomeprazole
keywords: artificial ulcer; endoscopic submucosal dissection; gastric carcinoma; proton pump inhibitor; vonoprazan