Comparison of the Efficacy of Polaprezinc Plus Proton Pump Inhibitor and Rebamipide Plus Proton Pump Inhibitor Treatments for Endoscopic Submucosal Dissection-induced Ulcers.

Abstract

GOALS:

We assessed the efficacy of polaprezinc plus proton pump inhibitor (PPI) treatment for endoscopic submucosal dissection (ESD)-induced ulcer healing compared with rebamipide plus PPI treatment.

BACKGROUND:

ESD has been widely used as a local treatment option that cures gastric neoplasms. However, it causes large and deep artificial ulcers, and there are no guidelines with regard to the optimal treatment durations and drug regimens for ESD-induced ulcers. Polaprezinc is effective for promoting ulcer healing and helps enhance the quality of ulcer healing.

STUDY:

Two hundred ten patients with ESD-induced ulcers were randomly allocated to treatment with polaprezinc (150 mg/d) plus pantoprazole (40 mg/d) or treatment with rebamipide (300 mg/d) plus pantoprazole (40 mg/d). We evaluated the ulcer healing rate and condition of the ulcer at 4 weeks after dissection. The χ2 or Fisher exact test and the Student t test were used.

RESULTS:

The ulcer healing rates at 4 weeks after dissection in the polaprezinc plus pantoprazole treatment group were not inferior compared with those in the rebamipide plus pantoprazole treatment group, both in the intention-to-treat analysis (90.3% and 91.4%, respectively, P=0.523) and per-protocol analysis (89.9% and 91.1%, respectively, P=0.531). The short procedure time was an independent predictive factor for a high ulcer healing rate (odds ratio: 0.975; 95% confidence interval: 0.958-0.993; P=0.006).

CONCLUSION:

The polaprezinc plus PPI treatment showed noninferiority to rebamipide plus PPI treatment in the ulcer healing rate at 4 weeks after ESD.

• Authors: Da Hyun Jung, Jun Chul Park, Yong Chan Lee, Sang Kil Lee, Sung Kwan Shin, Hyunsoo Chung, Jae Jun Park, Jie-Hyun Kim, Young Hoon Youn, Hyojin Park
• Journal: Journal of clinical gastroenterology (J Clin Gastroenterol) Vol. 55 Issue 3 Pg. 233-238 (03 01 2021) ISSN: 1539-2031 [Electronic] United States
• PMID: 32341237 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.

Chemical References

• Anti-Ulcer Agents
• Organometallic Compounds
• Proton Pump Inhibitors
• Quinolones
• Zinc Compounds
• polaprezinc
• Carnosine
• rebamipide
• Alanine

Topics

• Alanine (analogs & derivatives)
• Anti-Ulcer Agents (therapeutic use)
• Carnosine (analogs & derivatives)
• Drug Therapy, Combination
• Endoscopic Mucosal Resection (adverse effects)
• Humans
• Organometallic Compounds
• Proton Pump Inhibitors (therapeutic use)
• Quinolones
• Stomach Neoplasms (drug therapy)
• Stomach Ulcer (drug therapy, etiology)
• Ulcer
• Zinc Compounds