Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Nov 16;8(19):716-722.
doi: 10.4253/wjge.v8.i19.716.

Vonoprazan 20 mg vs lansoprazole 30 mg for endoscopic submucosal dissection-induced gastric ulcers

Kazuya Takahashi  1 , Yuichi Sato  1 , Junji Kohisa  1 , Jun Watanabe  1 , Hiroki Sato  1 , Kenichi Mizuno  1 , Satoru Hashimoto  1 , Shuji Terai  1
Affiliations

Vonoprazan 20 mg vs lansoprazole 30 mg for endoscopic submucosal dissection-induced gastric ulcers

Kazuya Takahashi et al. World J Gastrointest Endosc. .

Abstract

Aim: To compare the healing effects of vonoprazan and lansoprazole on gastric ulcers induced by endoscopic submucosal dissection (ESD).

Methods: Data were obtained from a total of 26 patients. Fourteen patients were randomized to the vonoprazan group and 12 were randomized to the lansoprazole group. Patients were administered either 20 mg vonoprazan or 30 mg lansoprazole per day after ESD. Endoscopic images just after ESD, on day 8, and on day 28 were used for the evaluation of the shrinking rate of ESD ulcers. The shrinking rates and the incidence of delayed bleeding were compared between the 2 groups.

Results: The shrinking rates of ESD ulcers on day 8 [vonoprazan group: 61.8% (range: 24.0%-91.1%), lansoprazole group: 71.3% (range: 25.2%-88.6%)] and on day 28 [vonoprazan group: 95.3% (range: 76.2%-100%), lansoprazole group: 97.2% (range: 81.1%-99.8%)] were not statistically different between the 2 groups. On day 28, most of the ulcers in both groups healed to more than 90%, whereas 3 of 14 (21.4%) in the vonoprazan group and 1 of 12 (8.3%) in the lansoprazole group had delayed ulcer healing, which was not statistically different (P = 0.356). The frequency of delayed bleeding was 0 in the both groups. Taken together, there were no significant differences between the two drug groups.

Conclusion: Our study indicates that vonoprazan is potent for the management of ESD ulcers although lansoprazole is also sufficient and cost-effective.

Keywords: Endoscopic submucosal dissection; Gastric cancer; Lansoprazole; Potassium-competitive acid blocker; Proton pump inhibitor; Vonoprazan.

PubMed Disclaimer

Conflict of interest statement

Conflict-of-interest statement: None declared.

Figures

Figure 1
Figure 1
Flow chart of the participants in the study. Thirty patients were enrolled and four of them were excluded because they needed additional surgery or violated the protocol. Finally, 14 patients in the vonoprazan group and 12 patients in the lansoprazole group were included in the analysis. ESD: Endoscopic submucosal dissection.
Figure 2
Figure 2
From the day of endoscopic submucosal dissection, intravenous infusion of proton pump inhibitor (lansoprazole 30 mg) was administered to all patients for 2 d. Then, oral intake was initiated and patients in the vonoprazan group were administered vonoprazan (20 mg daily) and patients in the lansoprazole group were administered lansoprazole (30 mg daily) until 28 d after ESD. Patients underwent follow-up EGD on day 8 and day 28. ESD: Endoscopic submucosal dissection; PPI: Proton pump inhibitor; iv: Intravenous injection.
Figure 3
Figure 3
A representative case in the lansoprazole group. The area inside the yellow line was calculated using ImageJ. We placed measuring forceps on the ulcer base to use as a scale. The ulcer base gradually shrank and there were no adverse events. The shrinking rates on days 8 and 28 were 27.1% and 96.3%, respectively.
See this image and copyright information in PMC

References

    1. Gotoda T, Yamamoto H, Soetikno RM. Endoscopic submucosal dissection of early gastric cancer. J Gastroenterol. 2006;41:929–942. - PubMed
    1. Oda I, Saito D, Tada M, Iishi H, Tanabe S, Oyama T, Doi T, Otani Y, Fujisaki J, Ajioka Y, et al. A multicenter retrospective study of endoscopic resection for early gastric cancer. Gastric Cancer. 2006;9:262–270. - PubMed
    1. Yang Z, Wu Q, Liu Z, Wu K, Fan D. Proton pump inhibitors versus histamine-2-receptor antagonists for the management of iatrogenic gastric ulcer after endoscopic mucosal resection or endoscopic submucosal dissection: a meta-analysis of randomized trials. Digestion. 2011;84:315–320. - PubMed
    1. Sachs G, Shin JM, Munson K, Vagin O, Lambrecht N, Scott DR, Weeks DL, Melchers K. Review article: the control of gastric acid and Helicobacter pylori eradication. Aliment Pharmacol Ther. 2000;14:1383–1401. - PubMed
    1. Shin JM, Inatomi N, Munson K, Strugatsky D, Tokhtaeva E, Vagin O, Sachs G. Characterization of a novel potassium-competitive acid blocker of the gastric H,K-ATPase, 1-[5-(2-fluorophenyl)-1-(pyridin-3-ylsulfonyl)-1H-pyrrol-3-yl]-N-methylmethanamine monofumarate (TAK-438) J Pharmacol Exp Ther. 2011;339:412–420. - PMC - PubMed