Evidence map›Paper›PMID 40132569›Full record

ArticleDigestion2025

Which of Vonoprazan Alone or Intravenous Proton Pump Inhibitor Followed by Vonoprazan Is Optimal for Reducing Delayed Bleeding in Gastric Endoscopic Submucosal Dissection?

Waku Hatta, Hiroko Abe, Kunio Tarasawa, Waku Hatta, Naotaro Tanno, Yutaka Hatayama, Yohei Ogata, Masahiro Saito, Xiaoyi Jin, Tomoyuki Koike and 5 more

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Digestion, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Waku Hatta
Hiroko AbeDivision of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Kunio TarasawaDepartment of Health Administration and Policy, Tohoku University Graduate School of Medicine, Sendai, Japan.
Waku HattaDivision of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Naotaro TannoDivision of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Yutaka HatayamaDivision of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Yohei OgataDivision of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Masahiro SaitoDivision of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Xiaoyi JinDivision of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Tomoyuki KoikeDivision of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Akira ImataniDivision of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Shin HamadaDivision of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Kenji FujimoriDepartment of Health Administration and Policy, Tohoku University Graduate School of Medicine, Sendai, Japan.
Kiyohide FushimiDepartment of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Tokyo, Japan.
Atsushi MasamuneDivision of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

<p>Introduction: In gastric endoscopic submucosal dissection (ESD), both vonoprazan alone and intravenous proton pump inhibitor (PPI) followed by vonoprazan have lower delayed bleeding risk than PPI alone. This study aimed to clarify an optimal acid-suppressive method in gastric ESD.

methodsThis population-based cohort study included patients who underwent gastric ESD on only vonoprazan (vonoprazan alone group) or intravenous PPI followed by vonoprazan (intravenous PPI group) using the Diagnosis Procedure Combination database in Japan between 2014 and 2021. The primary outcome was delayed bleeding. To balance the two comparison groups, propensity score matching (PSM), based on 18 variables, was performed; subsequently, to compare the bleeding outcome, logistic regression analysis was performed.

resultsOf 63,952 patients, 24,710 pairs were compared following PSM. The delayed bleeding risk in the vonoprazan alone group was similar to that in the intravenous PPI group (odds ratio [OR], 1.00; 95% confidence interval, 0.93-1.08; delayed bleeding rate, 5.9% vs. 5.9%). The results were consistent in some sensitivity and subgroup analyses; however, the result was modified by the status of antithrombotic agents (p for interaction = 0.029). In additional analyses, in patients with antithrombotic agent, the vonoprazan alone group had a higher delayed bleeding risk than the intravenous PPI group (OR, 1.15).

conclusionBoth vonoprazan alone and intravenous PPI followed by vonoprazan might be acceptable in gastric ESD when antithrombotic agents were not administered, whereas intravenous PPI followed by vonoprazan might be favorable in patients with antithrombotic agents. </p>.

Indexed as

Endoscopic Mucosal ResectionGastroscopyPostoperative HemorrhageProton Pump InhibitorsPyrrolesStomach NeoplasmsSulfonamidesAdministration, IntravenousAgedDrug Therapy, CombinationFemaleGastric MucosaHumansJapanMaleMiddle Aged1-(5-(2-fluorophenyl)-1-(pyridin-3-ylsulfonyl)-1H-pyrrol-3-yl)-N-methylmethanamineProton Pump InhibitorsPyrrolesSulfonamidesDelayed bleedingEndoscopic submucosal dissectionIntravenous proton pump inhibitorVonoprazan

Identifiers

PMID40132569
PMCPMC12060810

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.