Hamada K, et al. - In this single-center randomized phase II trial, the researchers evaluated the efficacy of vonoprazan in preventing delayed bleeding after gastric endoscopic submucosal dissection (ESD). For this analysis, a modified screened selection design was used with a threshold non-bleeding rate of 89% and an expected rate of 97%. The incidence of delayed bleeding, defined as endoscopically confirmed bleeding accompanied by hematemesis, melena, or a decrease in hemoglobin of ≥ 2 g/dl was the primary endpoint. In patients with an ESD-induced gastric ulcer, vonoprazan efficaciously decreased the delayed bleeding rate.