caa a22 4500 44588892X CHVBK 20180317145609.0 cr unu---uuuuu 170323e20110501xx s 000 0 eng 10.1007/s00535-011-0372-3 doi (NATIONALLICENCE)springer-10.1007/s00535-011-0372-3 A randomized controlled trial of rebamipide plus rabeprazole for the healing of artificial ulcers after endoscopic submucosal dissection [Elektronische Daten] [Shoko Fujiwara, Yoshinori Morita, Takashi Toyonaga, Fumi Kawakami, Tomoo Itoh, Masaru Yoshida, Hiromu Kutsumi, Takeshi Azuma] Background: Endoscopic submucosal dissection (ESD) is an increasingly common technique for the resection of early gastric cancers. Although 8weeks of treatment with a proton pump inhibitor (PPI) reportedly heals most patients with ESD-derived artificial ulcers, it does not heal those with severe atrophic gastritis, for whom there is little data. This study examined whether healing rates of the latter especially were improved by the addition of the non-PPI mucosal healing agent rebamipide after ESD. Methods: Patients were randomly assigned to two treatment groups for 8weeks following ESD: patients in the PPI group received daily rabeprazole alone (20mg), whereas those in the combination group received daily rabeprazole (20mg) and rebamipide (300mg). At the primary endpoint (56days after ESD) we determined the proportion of patients in whom ulcers had healed to scar-stage (S-stage, complete healing). A pre-specified subgroup analysis examined ulcer healing in patients with severe atrophic gastritis. Results: Overall, progression to S-stage occurred in 54.8% in the PPI group, and 86.7% in the combination group (odds ratio 5.3, 95% confidence interval 1.50-19.02, p=0.006). Among those patients with severe atrophic gastritis, healing to S-stage occurred in 30.0% in the PPI group, and in 92.9% in the combination group (odds ratio 30.3, 95% confidence interval 2.63-348.91, p=0.0023). Conclusion: Treatment with a PPI plus rebamipide improved healing rates at 8weeks for patients with ESD-derived artificial ulcer, and appeared to be particularly effective for patients with severe atrophic gastritis. Springer, 2011 ESD nationallicence Artificial ulcer nationallicence Atrophic gastritis nationallicence Rebamipide nationallicence PPI nationallicence Fujiwara Shoko Department of Gastroenterology, Kobe University, School of Medicine, Kobe, Japan aut Morita Yoshinori Department of Gastroenterology, Kobe University, School of Medicine, Kobe, Japan aut Toyonaga Takashi Department of Endoscopy, Kobe University, School of Medicine, Kobe, Japan aut Kawakami Fumi Department of Histopathology, Kobe University, School of Medicine, Kobe, Japan aut Itoh Tomoo Department of Histopathology, Kobe University, School of Medicine, Kobe, Japan aut Yoshida Masaru Department of Gastroenterology, Kobe University, School of Medicine, Kobe, Japan aut Kutsumi Hiromu Department of Gastroenterology, Kobe University, School of Medicine, Kobe, Japan aut Azuma Takeshi Department of Gastroenterology, Kobe University, School of Medicine, Kobe, Japan aut Journal of Gastroenterology Springer Japan 46/5(2011-05-01), 595-602 0944-1174 46:5<595 2011 46 535 https://doi.org/10.1007/s00535-011-0372-3 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00535-011-0372-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Fujiwara Shoko Department of Gastroenterology, Kobe University, School of Medicine, Kobe, Japan aut NATIONALLICENCE 700 1- Morita Yoshinori Department of Gastroenterology, Kobe University, School of Medicine, Kobe, Japan aut NATIONALLICENCE 700 1- Toyonaga Takashi Department of Endoscopy, Kobe University, School of Medicine, Kobe, Japan aut NATIONALLICENCE 700 1- Kawakami Fumi Department of Histopathology, Kobe University, School of Medicine, Kobe, Japan aut NATIONALLICENCE 700 1- Itoh Tomoo Department of Histopathology, Kobe University, School of Medicine, Kobe, Japan aut NATIONALLICENCE 700 1- Yoshida Masaru Department of Gastroenterology, Kobe University, School of Medicine, Kobe, Japan aut NATIONALLICENCE 700 1- Kutsumi Hiromu Department of Gastroenterology, Kobe University, School of Medicine, Kobe, Japan aut NATIONALLICENCE 700 1- Azuma Takeshi Department of Gastroenterology, Kobe University, School of Medicine, Kobe, Japan aut NATIONALLICENCE 773 0- Journal of Gastroenterology Springer Japan 46/5(2011-05-01), 595-602 0944-1174 46:5<595 2011 46 535 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer