Comparison of the Efficacy of Polaprezinc Plus Proton Pump Inhibitor and Rebamipide Plus Proton Pump Inhibitor Treatments for Endoscopic Submucosal Dissection-induced Ulcers.
Level 2 - randomized trial
Individual randomized controlled trial
PubMed 32341237 · doi:10.1097/MCG.0000000000001357
What was done
A randomized controlled trial evaluated the efficacy of polaprezinc plus a proton pump inhibitor compared with rebamipide plus a proton pump inhibitor in 210 patients with endoscopic submucosal dissection-induced gastric ulcers. Patients were randomly assigned to receive either polaprezinc at 150 mg/day plus pantoprazole at 40 mg/day or rebamipide at 300 mg/day plus pantoprazole at 40 mg/day. Ulcer healing rate and ulcer condition were evaluated at 4 weeks after dissection.
What was found
Ulcer healing rates at 4 weeks for polaprezinc plus pantoprazole were non-inferior to rebamipide plus pantoprazole in both the intention-to-treat analysis (90.3% vs 91.4%, P=0.523) and per-protocol analysis (89.9% vs 91.1%, P=0.531). Shorter procedure time was an independent predictive factor for a high ulcer healing rate (odds ratio 0.975, 95% confidence interval 0.958 to 0.993, P=0.006).
Why it matters
Polaprezinc combined with a proton pump inhibitor provides comparable 4-week ulcer healing efficacy to rebamipide-based regimens following endoscopic submucosal dissection.
Limits
The abstract does not report whether the trial was blinded or what formal non-inferiority margin was prespecified. Details on adverse events, lesion characteristics, and outcomes beyond 4 weeks are omitted.
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