The efficacy of vonoprazan for management of post‐endoscopic submucosal dissection ulcers compared with proton pump inhibitors: A meta‐analysis.

Objective: Artificial ulcers after endoscopic submucosal dissection (ESD) are usually treated by proton pump inhibitors (PPIs) in clinical setting. Vonoprazan, a newly developed potassium‐competitive acid blocker, has recently been used to treat post‐ESD ulcers. We aimed to evaluate the efficacy and safety of vonoprazan on the healing of post‐ESD artificial ulcers compared with those of proton pump inhibitors (PPIs) using a meta‐analysis. Methods: EMBASE, MEDLINE, Scopus and Cochrane Library databases were searched for all studies comparing the efficacy and safety of vonoprazan with those of PPIs in the treatment of post‐ESD ulcers. Results: Fourteen articles with 1328 patients were included in this meta‐analysis. When comparing ulcer shrinkage rate, vonoprazan showed a better efficacy than PPIs (mean difference 0.56, 95% confidence interval [CI] 0.18‐0.93). Vonoprazan also led to a higher scar formation rate (odds ratio [OR] 1.58, 95% CI 1.00‐2.47) and showed a potential superiority on reducing the risk of post‐ESD bleeding compared with PPIs, with a pooled OR of 0.69, although there was no statistically significant difference. Conclusions: Compared with PPIs, vonoprazan showed a better efficacy in ulcer shrinkage rate and achieved more complete healing in the treatment of post‐ESD ulcers. Vonoprazan did not induce any incremental risk of post‐ESD bleeding as well. It may be an appropriate choice in the management of artificial ulcers after ESD. [ABSTRACT FROM AUTHOR]