Comparison of rebamipide and tegoprazan combination therapy and tegoprazan monotherapy on the healing of endoscopic submucosal dissection-induced gastric ulcer: A randomized-controlled multicenter study
Abstract
Aims Currently, no consensus exists on optimal treatment for post-endoscopic submucosal dissection (ESD) gastric ulcer. This study aims to compare rebamipide and tegoprazan combination therapy with tegoprazan monotherapy for post-ESD ulcer healing [ 1 ] [ 2 ]. Methods Between May 2022 and September 2023, 140 patients (141 lesions) who underwent ESD for gastric epithelial neoplasms at five tertiary hospitals were randomly assigned to tegoprazan monotherapy or combination therapy groups. The size and stage of the post-ESD ulcers and ulcer healing quality were analyzed. Results A total of 132 and 121 lesions were included in the modified intention-to-treat (mITT) and per-protocol analyses, respectively. The ulcer healing rate at week 4 was significantly higher in the combination therapy group than in the tegoprazan monotherapy group (96.4% vs. 93.6%, P =0.02 in mITT analysis). Combination therapy significantly predicted higher-than-average ulcer healing at week 4 (odds ratio 2.28, 95% confidence interval 1.04–5.02, P =0.04). The proportion of flat ulcer scar at week 8 was significantly higher in the combination group than in the tegoprazan monotherapy group (73.8% vs. 48.4%, P =0.007). Conclusions Combination treatment with rebamipide and tegoprazan was superior to tegoprazan monotherapy for post-ESD ulcer healing, resulting in rapid post-ESD ulcer healing and the production of high-quality post-ESD ulcer and scar. Publication History Article published online: 27 March 2025 ©…
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Evidence Hub reads this as a randomized trial. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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