Polaprezinc noninferior to rebamipide as add-on to PPI for treating ulcer following ESD

In patients with endoscopic submucosal dissection (ESD)-induced ulcer, the combination of polaprezinc plus proton pump inhibitor (PPI) promotes healing as effectively as rebamipide plus PPI, as shown in a study.

Although widely used to treat gastric neoplasms, ESD causes large and deep artificial ulcers, researchers said, adding that there are no guidelines with regard to the optimal treatment durations and drug regimens for ESD-induced ulcers.

A total of 210 patients who had developed ulcer following ESD were randomized to receive treatment with either polaprezinc (150 mg/d) or rebamipide (300 mg/d) in addition to pantoprazole (40 mg/d). Researchers used χ2 or Fisher exact test and the Student t test to evaluate ulcer healing rate and its condition at 4 weeks after dissection.

Polaprezinc showed noninferiority to rebamipide in terms of ulcer healing rate 4 weeks following ESD both in the intention-to-treat analysis (90.3 percent vs 91.4 percent, respectively; p=0.523) and per-protocol analysis (89.9 percent vs 91.1 percent, respectively; p=0.531).

A short procedure time independently predicted a high ulcer healing rate (odds ratio, 0.975, 95 percent confidence interval, 0.958–0.993; p=0.006).

Polaprezinc is an antiulcer agent that inhibits proinflammatory cytokine-induced NF-κB activation and interleukin-8 expression in gastric epithelial cells, promoting ulcer healing. The drug is commonly prescribed for gastric ulcers in Japan. [Biol Trace Elem Res 2014;158:280-288]