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01-11-2019 | Proton Pump Inhibitors | Original Article—Alimentary Tract

Is the new potent acid-inhibitory drug vonoprazan effective for healing idiopathic peptic ulcers? A multicenter observational study in Akita Prefecture, Japan

Authors: Kae Sugawara, Shigeto Koizumi, Yohei Horikawa, Nobuya Mimori, Tsuyotoshi Tsuji, Hajime Ishii, Shusei Fujimori, Kengo Onochi, Hiroyuki Watanabe, Katsunori Iijima

Published in: Journal of Gastroenterology | Issue 11/2019

Abstract

Background

The incidence of peptic ulcers unrelated to H. pylori infection and non-steroidal anti-inflammatory drugs (NSAIDs), termed idiopathic peptic ulcers (IPUs), has increased worldwide. We recently reported that IPUs were refractory to proton pump inhibitor (PPI) treatment. Vonoprazan, which was recently developed in Japan, has shown a more potent acid-inhibitory effect than ordinary PPIs. In the present study, we compared the healing rates among peptic ulcers of different etiologies following treatment with vonoprazan.

Method

A multicenter observational study was performed at six participating hospitals in Akita Prefecture, Japan. Consecutive patients who had endoscopically confirmed gastro-duodenal ulcers were enrolled between August 2016 and March 2018. For each patient, the Helicobacter pylori infection status and NSAID use, including aspirin, were checked, and 20 mg vonoprazan was administered for 6 weeks for duodenal ulcers and 8 weeks for gastric ulcers. The healing status was checked by endoscopy at the end of vonoprazan treatment. Patients were divided into four subgroups according to the H. pylori status and NSAID usage.

Results

The proportion of IPUs was 18.2%. A total of 162 patients completed the study protocol. The healing rate of IPUs was marginally lower than that of simple H. pylori-associated ulcers (81.2% vs. 93.5%, P = 0.05). Similarly, the healing rate of NSAID-related ulcers, irrespective of concomitant H. pylori infection, was significantly lower than that of simple H. pylori-associated ulcers.

Conclusions

Six- or 8-week vonoprazan treatment still seems to be insufficient for healing IPUs. Longer-term vonoprazan or another treatment option may be required to heal potentially refractory peptic ulcers.

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Title: Is the new potent acid-inhibitory drug vonoprazan effective for healing idiopathic peptic ulcers? A multicenter observational study in Akita Prefecture, Japan
Authors: Kae Sugawara
Shigeto Koizumi
Yohei Horikawa
Nobuya Mimori
Tsuyotoshi Tsuji
Hajime Ishii
Shusei Fujimori
Kengo Onochi
Hiroyuki Watanabe
Katsunori Iijima
Publication date: 01-11-2019
Publisher: Springer Japan
Keywords: Proton Pump Inhibitors
Gastric Ulcer
Duodenal Ulcer
Published in: Journal of Gastroenterology / Issue 11/2019
Print ISSN: 0944-1174
Electronic ISSN: 1435-5922
DOI: https://doi.org/10.1007/s00535-019-01587-5

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Is the new potent acid-inhibitory drug vonoprazan effective for healing idiopathic peptic ulcers? A multicenter observational study in Akita Prefecture, Japan

Abstract

Background

Method

Results

Conclusions

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