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Title: Vonoprazan versus proton-pump inhibitors for gastric endoscopic submucosal dissection-induced ulcers: A systematic review and meta-analysis
Authors: Veeravich Jaruvongvanich
Kittika Poonsombudlert
Patompong Ungprasert
King Chulalongkorn Memorial Hospital, Faculty of Medicine Chulalongkorn University
University of Hawaii at Manoa
Faculty of Medicine, Siriraj Hospital, Mahidol University
Keywords: Medicine
Issue Date: 1-Dec-2018
Citation: European Journal of Gastroenterology and Hepatology. Vol.30, No.12 (2018), 1416-1421
Abstract: © 2018 Wolters Kluwer Health, Inc. All rights reserved. Acid secretion inhibitors are usually prescribed to promote the healing of artificial ulcers caused by endoscopic submucosal dissection (ESD) to reduce the risk of gastric perforation and delayed bleeding. Vonoprazan is a newer agent that has been shown to be more potent than a proton-pump inhibitor (PPI). However, it remains unclear whether vonoprazan is more effective than PPI in promoting healing of ulcers caused by ESD. Medline and Embase databases were searched through January 2018 for studies that compared the rate of complete healing of ulcers caused by ESD and post-ESD delayed bleeding in patients who received vonoprazan versus those who received PPI after ESD. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using a random-effect model, generic inverse variance method. The between-study heterogeneity was quantified using the Q-statistic and I 2. A total of six studies consisting of 461 patients were identified. The likelihood that ulcers caused by ESD were completely healed at 4-8 weeks after the procedure was significantly higher among patients who received vonoprazan compared with those who received PPI, with a pooled OR of 2.27 (95% CI=1.38-3.73; I 2 =0%). The risk of developing post-ESD delayed bleeding was also numerically lower among those who received vonoprazan, with a pooled OR of 0.79, although the result did not reach statistical significance (95% CI=0.18-3.49; I 2 =29%). This study found that patients who received vonoprazan after ESD had a significantly higher rate of completely healed ulcers compared with those who received PPI.
ISSN: 14735687
Appears in Collections:Scopus 2018

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