The effect of proton pump inhibitors and vonoprazan on the development of ‘gastric mucosal redness’
- Authors:
- Satoshi Shinozaki
- Hiroyuki Osawa
- Yoshimasa Miura
- Yoshikazu Hayashi
- Hirotsugu Sakamoto
- Tomonori Yano
- Alan Kawarai Lefor
- Hironori Yamamoto
View Affiliations
Affiliations: Shinozaki Medical Clinic, Utsunomiya, Tochigi 321‑3223, Japan, Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Tochigi 329‑0498, Japan, Department of Surgery, Jichi Medical University, Shimotsuke, Tochigi 329‑0498, Japan
- Published online on: May 6, 2022 https://doi.org/10.3892/br.2022.1534
-
Article Number:
51
-
Copyright: © Shinozaki
et al. This is an open access article distributed under the
terms of Creative
Commons Attribution License.
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Abstract
The safety of long‑term proton pump inhibitor (PPI) and vonoprazan (VPZ) use is a relatively recent concern. Gastric mucosal redness was reported as a VPZ‑associated lesion in a previous study. The aim of this study was to investigate the prevalence and risk factors for gastric mucosal redness. Between December 2020 and November 2021, 1,101 patients who underwent esophagogastroduodenoscopy were reviewed. The cohort was divided into four groups: Control (n=580), histamine‑2 receptor antagonist (H2RA) (n=65), PPI (n=146) and VPZ groups (n=310). Gastric mucosal redness was present in 48/1,101 patients (4%). The prevalence in controls, H2RA, PPI and VPZ groups was 1.9% (11/580), 1.5% (1/65), 6.2% (9/146) and 8.7% (27/310), respectively. Both the PPI and VPZ groups had a significantly higher prevalence of gastric mucosal redness compared with the control group (P<0.001). In the multivariate analysis, PPI and VPZ use were significantly associated with gastric mucosal redness. Fundic gland polyps, gastric hyperplastic polyps, multiple white and flat elevated lesions, cobblestone‑like mucosa, and stardust gastric mucosa were also significantly associated with PPI and VPZ use in the multivariate analysis. Back‑to‑back analysis showed that gastric mucosal redness was not seen before starting PPI/VPZ in most patients. The duration of treatment with VPZ was investigated to determine if it affected the prevalence of gastric mucosal redness. There were no significant differences in treatment duration among patients with and without gastric mucosal redness (mean ± standard deviation: 3.0±1.5 vs. 2.5±1.4 years, P=0.077). In conclusion, the prevalence of gastric mucosal redness was low but was associated with PPI and VPZ use.
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