Tomita T et al. – Proton pump inhibitors (PPIs) are not superior to histamine–2 receptor antagonists (H2RAs) for the prevention of delayed bleeding or the healing of artificially induced ulcers after endoscopic submucosal dissection (ESD).Methods
- A total of 158 patients (155 early gastric cancers and 3 adenomas) were randomly assigned to the PPI group (omeprazole 20 mg/day) or H2RA group (famotidine 40 mg/day) in a prospective randomized controlled trial.
- The primary end point was the incidence of hematemesis, melena, and/or a decrease in hemoglobin level of 2 g/dL or more requiring endoscopic hemostatic treatment.
- ESD-induced ulcer healing and changes in ulcer size were also compared at 6 weeks after ESD as a secondary end point.
- Of the 158 patients, 2 were excluded from analysis because they had been treated with a PPI before the present study.
- Accordingly, data from 77 PPI and 79 H2RA subjects were included for analysis.
- Delayed bleeding after ESD occurred in 6.5% of subjects (PPI group) and in 6.3% (H2RA group); there was no significant difference between the 2 groups.
- Likewise, the two groups were not significantly different with respect to ulcer stage or ulcer size reduction rate.