Procedure-induced ulcers respond similarly to 4- and 8-week regimens
A 2014 RCT assessed the effect of 4 and 8 weeks of PPI treatment on healing of gastric ulcers resulting from endoscopic submucosal dissection (ESD), a procedure used to treat early gastric cancer or adenoma that leaves a large ulcer at the site.3 The study randomly assigned 84 patients to treatment with lansoprazole 30 mg/d for 4 or 8 weeks after undergoing ESD. Exclusion criteria included NSAID use or ingestion of mucosal protective agents within 4 weeks of the procedure, illness that might influence PPI effects, history of gastric surgery, and pregnancy or breastfeeding.
All patients underwent endoscopy the day after ESD and again at 8 weeks. Ulcer dimension (mm2) was determined by multiplying the longest diameter by the diameter perpendicular to the longest diameter. The ulcer reduction ratio, an assessment of healing, was determined by dividing the ulcer dimension at 8 weeks after ESD by the initial ulcer dimension.
No significant difference was observed in the 4-week and 8-week groups in terms of ulcer healing (68% vs 69%, respectively; P=.93) or the ulcer reduction ratio (0.0081 vs 0.0037, respectively; P=.15).