The effect of proton pump inhibitors and vonoprazan on the development of ‘gastric mucosal redness’

Shinozaki,Satoshi; Osawa,Hiroyuki; Miura,Yoshimasa; Hayashi,Yoshikazu; Sakamoto,Hirotsugu; Yano,Tomonori; Lefor,Alan Kawarai; Yamamoto,Hironori

doi:10.3892/br.2022.1534

June-2022 Volume 16 Issue 6

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June-2022 Volume 16 Issue 6

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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
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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

Copyright: © Shinozaki et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Article Number: 51
|
Published online on: May 6, 2022

https://doi.org/10.3892/br.2022.1534
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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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1	Sakurai Y, Mori Y, Okamoto H, Nishimura A, Komura E, Araki T and Shiramoto M: Acid-inhibitory effects of vonoprazan 20 mg compared with esomeprazole 20 mg or rabeprazole 10 mg in healthy adult male subjects-a randomised open-label cross-over study. Aliment Pharmacol Ther. 42:719–730. 2015.PubMed/NCBI View Article : Google Scholar
2	Shinozaki S, Osawa H, Hayashi Y, et al: Changes in gastric morphology during long-term use of vonoprazan compared to proton pump inhibitors. Singapor Med J (in press): Accepted on April 24, 2021.
3	Yoshizaki T, Morisawa T, Fujinami M, Matsuda T, Katayama N, Inoue K, Matsumoto M, Ikeoka S, Takagi M, Sako T, et al: Propensity score matching analysis: Incidence and risk factors for ‘stardust’ gastric mucosa, a novel gastric finding potentially induced by vonoprazan. Aliment Pharmacol Ther. 53:94–102. 2021.PubMed/NCBI View Article : Google Scholar
4	Kubo K, Kimura N, Matsuda S, Tsuda M, Mabe K and Kato M: Vonoprazan-associated gastric mucosal redness: A report of four cases. Intern Med. 59:507–511. 2020.PubMed/NCBI View Article : Google Scholar
5	Kubo K, Kimura N, Watanabe R, Higashino M, Tsuda M and Kato M: Vonoprazan-associated gastric mucosal redness in non-Helicobacter pylori-infected and Helicobacter pylori-eradicated stomach. Case Rep Gastroenterol. 15:751–758. 2021.PubMed/NCBI View Article : Google Scholar
6	Shinozaki S, Osawa H, Hayashi Y, Lefor AK and Yamamoto H: Linked color imaging for the detection of early gastrointestinal neoplasms. Therap Adv Gastroenterol. 12(1756284819885246)2019.PubMed/NCBI View Article : Google Scholar
7	Kimura K and Takemoto T: An endoscopic recognition of the atrophic border and its significance in chronic gastritis. Endoscopy. 1:87–97. 1969.
8	Hasegawa R, Yao K, Ihara S, Miyaoka M, Kanemitsu T, Chuman K, Ikezono G, Hirano A, Ueki T, Tanabe H, et al: Magnified endoscopic findings of multiple white flat lesions: A new subtype of gastric hyperplastic polyps in the stomach. Clin Endosc. 51:558–562. 2018.PubMed/NCBI View Article : Google Scholar
9	Miyamoto S, Kato M, Tsuda M, Matsuda K, Muranaka T, Abiko S, Ono M, Mizushima T, Omori S, Yamamoto K, et al: Gastric mucosal cracked and cobblestone-like changes resulting from proton pump inhibitor use. Dig Endosc. 29:307–313. 2017.PubMed/NCBI View Article : Google Scholar

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

The effect of proton pump inhibitors and vonoprazan on the development of ‘gastric mucosal redness’

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