Comparative efficacy of various anti-ulcer medications after gastric endoscopic submucosal dissection: a systematic review and network meta-analysis.

Surgical Endoscopy
Eun Hye KimChan Hyuk Park

Abstract

The comparative efficacy of various anti-ulcer medications after gastric endoscopic submucosal dissection (ESD) has not been fully evaluated. Recently, vonoprazan, a novel potassium-competitive acid blocker, has also been used in ulcer treatment after ESD. We searched for all relevant randomized controlled trials examining the efficacy of anti-ulcer medications after gastric ESD, published through October 2017. Healing of iatrogenic ulcers was investigated at 4-8 weeks after ESD. A network meta-analysis was performed to calculate the network estimates. Twenty-one studies with 2005 patients were included. Concerning the comparative efficacy for ulcer healing at 4 weeks after ESD, no network inconsistency was identified (Cochran's Q-test, df = 10, P = 0.13; I2 = 34%). A combination therapy of proton-pump inhibitor (PPI) and muco-protective agent was superior to PPI alone [risk ratio (RR) (95% confidence interval, CI) 1.69 (1.20-2.39)]. The combination therapy of PPI and muco-protective agents tended to be superior to vonoprazan [RR (95% CI) 1.98 (0.99-3.94)]. There was no difference of ulcer healing effect between PPI and vonoprazan [RR (95% CI) PPI vs. vonoprazan, 1.17 (0.64-2.12)]. Concerning the ulcer healing rate at 8 weeks a...Continue Reading

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Citations

Apr 30, 2020·Clinical and Experimental Gastroenterology·Elisa MarabottoEdoardo Savarino
May 26, 2020·The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi·Chan Hyuk ParkHoon Jai Chun
Feb 13, 2020·Journal of Digestive Diseases·Chao Hu YangRui Hua Shi
Apr 8, 2020·Clinical Endoscopy·Chan Hyuk ParkHoon Jai Chun
Oct 14, 2020·Intestinal research·Chan Hyuk ParkHoon Jai Chun
Sep 23, 2021·Expert Review of Gastroenterology & Hepatology·Vincenzo SavarinoEdoardo Savarino

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