LAUSR

OBJECTIVE As a result of resection, artificial ulcers were created after Endoscopic submucosal dissection (ESD). In order to heal the ulcers as soon as possible, vonoprazan, a novel potassium competitive acid blocker, which may have a better efficacy, was used in some studies. A meta-analysis was performed to evaluate the efficacy and safety of vonoprazan on the healing of artificial ulcers after ESD compared to PPIs. METHODS Embase, Medline, Scopus and Cochrane Library were searched for all studies that associated with the treatment of post-ESD ulcers. A meta-analysis was performed to compare the efficacy between PPIs and vonoprazan on the coalescence of post-ESD ulcers. RESULTS 14 citations consisted of 1429 patients were involved in this study. When comparing ulcer contraction rate, Vonoprazan showed a better efficacy than PPIs (MD [95% CI] = 0.56 [0.18-0.93]). Vonoprazan also led to a higher scar formation rate when the treatment course was equal (OR [95% CI] =1.58 [1.00-2.47]) and showed a potential superiority on reducing the risk of post-ESD bleeding rate than those who used PPIs with a pooled OR of 0.69 but without statistically significant difference. CONCLUSION Vonoprazan showed a better efficacy in ulcer size contraction rate and achieved more completely healing in the treatment of post-ESD ulcers, and didn't induce any incremental risk of post-ESD bleeding compared with PPIs. Vonoprazan can be an appropriate choice in the management of artificial ulcers after ESD. This article is protected by copyright. All rights reserved.