According to the findings of a retrospective cohort study published in Gastrointestinal Endoscopy, vonoprazan may be suggested for post-endoscopic submucosal dissection (ESD) bleeding in the stomach since it exhibits a lower bleeding rate when compared to proton pump inhibitors (PPIs).

This nationwide population-based study was carried out to examine the post-ESD bleeding rates between PPIs and vonoprazan. The study involved nine hospitals. Following two days of intravenous administration of PPI, either vonoprazan or PPI was given from postsurgery day 2 to day 30.

Overall, data of 1,715 participants (627 patient pairs) were assessed through propensity score matching in this multicentre study. The vonoprazan group exhibited remarkably reduced post-ESD bleeding rates and reduced readmission rate due to post-ESD bleeding compared to the PPI group, as shown in Table 1:

Both the groups demonstrated comparable blood transfusion and additional surgery because of delayed perforation. In both groups, no deaths were reported to occur within 30 days. On the Cox regression assessment, direct oral anticoagulant usage, vonoprazan usage, lesion location (antrum), Charlson Comorbidity Index (≥2), and aspirin usage were linked with a raised risk of post-ESD bleeding within 30 days.

Vonoprazan seems to be beneficial for minimizing the post-ESD bleeding rate. However, there is a requirement for future prospective studies to validate these outcomes.