A Matched Case-Control Study of a Novel Acid-Pump Antagonist and Proton-Pump Inhibitor for the Treatment of Iatrogenic Ulcers Caused by Endoscopic Submucosal Dissection
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Background/Aims: Revaprazan, a novel acid-pump antagonist, and proton-pump inhibitors (PPIs) have pH-independent effects on ulcer healing. The addition of a PPI promotes the cell restitution rate as well as vessel regeneration and maturation for ulcer repair. Revaprazan is known to protect the mucosa by increasing the prostaglandin concentration. Methods:We reviewed the medical records of patients who underwent endoscopic submucosal dissection (ESD) for gastric neoplasia at Yeungnam University Hospital between January 2008 and May 2009. We conducted a matched case-control study to compare the healing rates effected by revaprazan and rabeprazole. Results: Each group consisted of 30 patients. The baseline characteristics did not differ significantly between the two groups. Stage S1 disease was observed in 97% and 100% of patients after 8 weeks of treatment in the revaprazan and rabeprazole groups,respectively. In the revaprazan group, only one patient had stage H2 disease: a 54-year-old man with a 5.5-cm lesion after ESD of the ulcer, type IIa early gastric cancer, and adenocarcinoma. No serious adverse effects occurred during the treatment period in either group. Conclusions: The safety and efficacy profiles of revaprazan and rabeprazole are similar for the treatment of ESD-induced ulcers.
Abstract
Background/Aims: Revaprazan, a novel acid-pump antagonist, and proton-pump inhibitors (PPIs) have pH-independent effects on ulcer healing. The addition of a PPI promotes the cell restitution rate as well as vessel regeneration and maturation for ulcer repair. Revaprazan is known to protect the mucosa by increasing the prostaglandin concentration. Methods:We reviewed the medical records of patients who underwent endoscopic submucosal dissection (ESD) for gastric neoplasia at Yeungnam University Hospital between January 2008 and May 2009. We conducted a matched case-control study to compare the healing rates effected by revaprazan and rabeprazole. Results: Each group consisted of 30 patients. The baseline characteristics did not differ significantly between the two groups. Stage S1 disease was observed in 97% and 100% of patients after 8 weeks of treatment in the revaprazan and rabeprazole groups,respectively. In the revaprazan group, only one patient had stage H2 disease: a 54-year-old man with a 5.5-cm lesion after ESD of the ulcer, type IIa early gastric cancer, and adenocarcinoma. No serious adverse effects occurred during the treatment period in either group. Conclusions: The safety and efficacy profiles of revaprazan and rabeprazole are similar for the treatment of ESD-induced ulcers.
참고문헌 (31)
- Sachs G, "Proton pump inhibitors and acid-related diseases", Pharmacotherapy, 17, pp.22~37 (1997)
- Pope AJ, "Properties of the reversible K(+)-competitive inhibitor of the gastric (H+", K+)-ATPase, SK&F 97574. I. In vitro activity, 1995, pp.50, 1543~1549
- Akimoto M, "Effects of antisecretory agents on angiogenesis during healing of gastric ulcers", J Gastroenterol, 40, pp.685~689 (2005)
- Okazaki M, "Gastric mucosal levels of prostaglandins and leukotrienes in patients with gastric ulcer after treatment with rabeprazole in comparison to treatment with ranitidine", J Med Invest, 54, pp.83~90 (2007)
- Yeo M, "The novel acid pump an tagonists for anti-secretory actions with their peculiar applications beyond acid suppression", J Clin Biochem Nutr, 38, pp.1~8 (2006)
- Ono H, "Endoscopic submucosal dissection for early gastric cancer", Chin J Dig Dis, 6, pp.119~121 (2005)
- Sakita T, "Fukutomi H. Endoscopic diagnosis. In Ulcer of stomach and duodenum", pp.198~208 (1971), Nankodo
- Howden CW, "The treatment of gastric ulcer with antisecretory drugs: relationship of pharmacological effect to healing rates", DigDis Sci, 33, pp.619~624 (1988)
- Oh TH, "Degree of healing and healing-associated factors of endoscopic submucosal dissection-induced ulcers after pantoprazole therapy for 4weeks", Dig Dis Sci, 54, pp.1494~1499 (2009)
- Hashimoto T, "Changes in gastric mucosal blood flow during healing of EMR-induced ulcer: comparison with peptic ulcer", Dig Endosc, 9, pp.127~131 (1997)
- Kakushima N, "The healing process of gastric artificial ulcers after endoscopic submucosal dissection", Dig Endosc, 16, pp.327~331 (2004)
- Panes J, "Effects of acute normovolemic anemia on gastric mucosal blood flow in rats: role of nitric oxide", Gastroenterology, 103, pp.407~413 (1992)
- Tarnawski A, "Increased expression of epidermal growth factor receptor during gastric ulcer healing in rats", Gastroenterology, 102, pp.695~698 (1992)
- Lee SY, "Healing rate of EMR-induced ulcer in relation to the duration of treatment with omeprazole", Gastrointest Endosc, 60, pp.213~217 (2004)
- Sachs G, "S. The pharmacology of the gastric acid pump: the H+,K+ ATPase", Annu Rev Pharmacol Toxicol, 35, pp.277~305 (1995)
- Yoshida N, "A new mechanism for anti-inflammatory actions of proton pump inhibitors: inhibitory effects on neutrophil-endothelial cell interactions", Aliment Pharmacol Ther, 14(Suppl 1), pp.74~81 (2000)
- Suzuki M, "Omeprazole attenuates oxygen-derived free radical production from human neutrophils", Free Radic Biol Med, 21, pp.727~731 (1996)
- Wandall JH, "Effects of omeprazole on neutrophil chemotaxis, super oxide production, degranulation, and translocation of cytochrome b-245", Gut, 33, pp.617~621 (1992)
- McCabe RD, "Evidence of a K(+)-H(+)-ATPase in vascular smooth muscle cells", Am J Physiol, 262, pp.H1955~H1958 (1992)
- Suzuki H, "Lansoprazole promotes gastric mucosal cell proliferation and migration by activating p44", p42 mitogen-activated protein kinase, 2004, pp.12, 93~99
- 장린, "위궤양에 대한 레바프라잔 정제의 제3상 임상시험", Clinical Endoscopy, 34(6), pp.312~319 (2007), 대한소화기내시경학회
- 최명규, "위염에 대한 레바프라잔 정제의 제3상 임상시험", Clinical Endoscopy, 33(4), pp.212~219 (2006), 대한소화기내시경학회
- 정인식, "십이지장궤양에 대한 레바프라잔 정제의 제3상 임상시험", Clinical Endoscopy, 31(1), pp.17~24 (2005), 대한소화기내시경학회
- Yu KS, "Pharmacokinetic and pharmacodynamic evaluation of a novel proton pump inhibitor, YH1885, in healthy volunteers", J Clin Pharmacol, 44, pp.73~82 (2004)
- Elso CM, "Heightened susceptibility to chronic gastritis, hyperplasia and metaplasia in Kcnq1 mutant mice", Hum Mol Genet, 13, pp.2813~2821 (2004)
- Roepke TK, "The KCNE2 potassium channel ancillary subunit is essential for gastricacid secretion", J Biol Chem, 281, pp.23740~23747 (2006)
- Franic TV, "Regulation of gastric epithelial cell development revealed in H(+)", K(+)-ATPase beta-subunit- and gastrin-deficient mice, 2001, pp.281, G1502~G1511
- Masaoka T, "Gastric epithelial cell modality and proton pump inhibitor", J Clin Biochem Nutr, 42, pp.191~196 (2008)
- Driman DK, "Omeprazole produces parietal cell hypertrophy and hyperplasia in humans", Dig Dis Sci, 41, pp.2039~2047 (1996)
- Bajaj JS, "Association of proton pump inhibitor therapy with spontaneous bacterial peritonitis in cirrhotic patients with ascites", Am J Gastroenterol, 104, pp.1130~1134 (2009)
- pyridazine (CS-526), a novel acid pump antagonist, on gastric acid secretion and gastrin levels in rats, "J Pharmacol Exp Ther", 2008, 163~170