Gastric ulcer

Summary

Gastric ulcer (MONDO:0001126) is a disease with 56 GWAS associations across 34 studies and 81 clinical trials. Top therapeutic interventions include vonoprazan, lansoprazole, and rabeprazole. A subtype of peptic ulcer disease — broader associated-gene and molecular evidence is on the parent page (see Disease family below).

At a glance

• GWAS associations: 56
• Clinical trials: 81

Clinical features

No curated clinical features (Orphanet) for this disease.

Identifiers

Disease identifiers

Field	Value
Canonical name	gastric ulcer
Mondo ID	MONDO:0001126
EFO	EFO:0009454
MeSH	D013276
DOID	DOID:10808
ICD-10-CM	K25
ICD-11	1437411258
NCIT	C3388
SNOMED CT	397825006
UMLS	C0038358
MedGen	21330
Anatomy (UBERON)	UBERON:0000945
Is cancer (heuristic)	no

Also known as: acute gastric ulcer with haemorrhage and obstruction · acute gastric ulcer with haemorrhage and perforation · acute gastric ulcer with haemorrhage and perforation, with obstruction · acute gastric ulcer with haemorrhage and perforation, without mention of obstruction · acute gastric ulcer with haemorrhage and with perforation but without obstruction · acute gastric ulcer with hemorrhage and obstruction · acute gastric ulcer with hemorrhage and perforation · acute gastric ulcer with hemorrhage and perforation, with obstruction · acute gastric ulcer with hemorrhage and perforation, without mention of obstruction · acute gastric ulcer with hemorrhage and with perforation but without obstruction · acute gastric ulcer with hemorrhage, with obstruction · acute gastric ulcer with hemorrhage, with perforation and with obstruction · acute gastric ulcer with perforation · acute gastric ulcer with perforation and obstruction · acute gastric ulcer with perforation, with obstruction · acute gastric ulcer without haemorrhage and without perforation · acute gastric ulcer without hemorrhage and without perforation · acute gastric ulcer without hemorrhage, without perforation and without obstruction · acute gastric ulcer without mention of haemorrhage or perforation, without mention of obstruction · acute gastric ulcer without mention of hemorrhage or perforation, without mention of obstruction (+11 more)

Data availability: 56 GWAS associations (34 studies) · 1 HPO phenotype.

Disease family

This is a subtype of peptic ulcer disease. Genetic, therapeutic, and trial evidence is largely curated at the broader-term level — see the parent page for the associated-gene cohort and molecular evidence.

Classification path: disease › human disease › disease by body system or component › digestive system disorder › peptic ulcer disease › gastric ulcer

Related subtypes (5): gastrojejunal ulcer, active peptic ulcer disease, peptic ulcer perforation, duodenal ulcer, peptic esophagitis

Subtypes (1): gastroduodenitis

Genetics & variants

GWAS landscape

56 GWAS associations across 34 studies. Top hits map to 21 distinct genes (as reported by GWAS).

Top associations by p-value

rsID	p-value	Gene	Risk allele	Odds ratio
rs2294008	1e-58	JRK, PSCA	T	0.43
rs34635647	5e-39	JRK, PSCA	G	0.14
rs143484304	1e-38	PSCA, JRK	T	0.14
rs35464379	3e-25	PSCA - LY6K	C	0.11
rs2976397	6e-24	PSCA - LY6K	T	0.13
rs183178550	4e-13	KCNJ5-AS1	A	2.59
rs147504619	2e-12	NPEPPSP1 - MRPL45	C	1.78
rs681343	3e-12	FUT2	?	0.91
rs558685191	4e-12	PPM1AP1 - RPL32P19	C	2.62
rs76036799	5e-12	IRF4 - EXOC2	C	3.19
rs542975891	6e-12	LINC03109, LINC02006	C	3.02
rs544767983	6e-12	TMEM244 - L3MBTL3	T	3.29
rs552964187	1e-11	LRRK2	G	2.37
rs74607779	1e-11	MUC5AC	G	1.82
rs545934910	2e-11	MRPS33P3 - RPF2P2	A	1.67
rs189578345	2e-11	ZNF970P - AK6P2	A	2.54
rs2920281	3e-11	JRK, PSCA	?	0.91
rs529776754	3e-11	ALK - YPEL5	C	1.77
rs767453489	3e-11	MIR4634 - LINC01951	G	2.38
rs184829320	4e-11	VAPA - LINC01254	A	2.87
rs687621	1e-10	ABO	?	0.91
rs1205531	2e-10	RNU6-309P - GAPDHP77	T	0.07
rs17866912	3e-10	PRELID3BP10 - ZNF800	G	0.15
rs6860328	6e-10	TTC33	C	0.07
rs546238399	9e-10	PRKAA1	CTCT	0.07
rs8114689	2e-09	GNAS	A	0.06
rs6026576	2e-09	GNAS	G	0.16
rs147048677	2e-09	MUC1	?	1.18
chr11:17642804	2e-09		A	2.68
rs4685405	3e-09	PLCL2	T	0.06

Top studies (by case count)

Study	Lead author	Year	Cases	Controls	Title
GCST90432136	Jiang Y	2023	116,382	213,325	A cross-disorder study to identify causal relationships, shared genetic variants, and genes across 21 digestive disorders.
GCST90270927	He Y	2023	20,972	240,675	East Asian-specific and cross-ancestry genome-wide meta-analyses provide mechanistic insights into peptic ulcer disease.
GCST90270931	He Y	2023	20,972	240,675	East Asian-specific and cross-ancestry genome-wide meta-analyses provide mechanistic insights into peptic ulcer disease.
GCST90018631	Sakaue S	2021	12,650	161,227	A cross-population atlas of genetic associations for 220 human phenotypes.
GCST90473779	UK Biobank Whole-Genome Sequencing Consortium	2025	12,139	446,301	Whole-genome sequencing of 490,640 UK Biobank participants.
GCST90667756	UK Biobank Whole-Genome Sequencing Consortium	2025	12,139	446,301	Whole-genome sequencing of 490,640 UK Biobank participants.
GCST90651695	Liu TY	2025	12,035	202,293	Diversity and longitudinal records: Genetic architecture of disease associations and polygenic risk in the Taiwanese Han population.
GCST90018851	Sakaue S	2021	6,293	467,985	A cross-population atlas of genetic associations for 220 human phenotypes.
GCST90080197	Backman JD	2021	5,549	381,689	Exome sequencing and analysis of 454,787 UK Biobank participants.
GCST90084183	Backman JD	2021	5,549	381,689	Exome sequencing and analysis of 454,787 UK Biobank participants.

Variant details and genetic-evidence tiers

Tier distribution (top 50 variants)

Tier	Variants
Tier 1: coding	4
Tier 2: splice/UTR	2
Tier 3: regulatory	0
Tier 4: intronic/intergenic	41

MAF distribution

Bucket	Variants
common (>=0.05)	25
low_freq (0.01-0.05)	0
rare (<0.01)	14
unknown	8

Functional consequences

Consequence	Count
intron_variant	17
intergenic_variant	16
unknown	6
missense_variant	2
synonymous_variant	2
5_prime_UTR_variant	1
stop_gained	1
frameshift_variant	1
3_prime_UTR_variant	1

Top variants

rsID	Chr	Pos	Alleles	MAF	Consequence	Gene	p-value	Tier
rs2294008	8	142680513	C>T	0.358	5_prime_UTR_variant	JRK, PSCA	1e-58	Tier 2: splice/UTR
rs34635647	8	142675472	A>G	0.377	intergenic_variant	JRK, PSCA	5e-39	Tier 4: intronic/intergenic
rs143484304	8	142678949		0.366	intergenic_variant	PSCA, JRK	1e-38	Tier 4: intronic/intergenic
rs35464379	8	142698205	CTT>C,CT,CTTT,CTTTT	0.05	intergenic_variant	PSCA - LY6K	3e-25	Tier 4: intronic/intergenic
rs2976397	8	142683195	G>A,C,T	0.496	intergenic_variant	PSCA - LY6K	6e-24	Tier 4: intronic/intergenic
rs183178550	11	128883365	A>G	0.001	intron_variant	KCNJ5-AS1	4e-13	Tier 4: intronic/intergenic
rs147504619	17	38266717	C>T	0.003	intergenic_variant	NPEPPSP1 - MRPL45	2e-12	Tier 4: intronic/intergenic
rs681343	19	48703205	C>A,T	0.05	stop_gained	FUT2	3e-12	Tier 1: coding
rs558685191	8	15864638	C>A,T	0	intergenic_variant	PPM1AP1 - RPL32P19	4e-12	Tier 4: intronic/intergenic
rs76036799	6	445634	C>T	0	intergenic_variant	IRF4 - EXOC2	5e-12	Tier 4: intronic/intergenic
rs542975891	3	153420017	C>T	0	intron_variant	LINC03109, LINC02006	6e-12	Tier 4: intronic/intergenic
rs544767983	6	129965131	T>C	0	intergenic_variant	TMEM244 - L3MBTL3	6e-12	Tier 4: intronic/intergenic
rs552964187	12	40325063	G>A	0	intron_variant	LRRK2	1e-11	Tier 4: intronic/intergenic
rs74607779	11	1160635	G>A,C	0.001	missense_variant	MUC5AC	1e-11	Tier 1: coding
rs545934910	4	115240446	A>G	0.003	intergenic_variant	MRPS33P3 - RPF2P2	2e-11	Tier 4: intronic/intergenic
rs189578345	12	38039429	A>T	0	intergenic_variant	ZNF970P - AK6P2	2e-11	Tier 4: intronic/intergenic
rs2920281	8	142679026	C>G,T	0.05	intergenic_variant	JRK, PSCA	3e-11	Tier 4: intronic/intergenic
rs529776754	2	30115642	C>T	0.002	intron_variant	ALK - YPEL5	3e-11	Tier 4: intronic/intergenic
rs767453489	5	174806394	G>A	0	intron_variant	MIR4634 - LINC01951	3e-11	Tier 4: intronic/intergenic
rs184829320	18	10338771	A>G	0	intron_variant	VAPA - LINC01254	4e-11	Tier 4: intronic/intergenic
rs687621	9	133261662	G>A,C,T	0.05	intron_variant	ABO	1e-10	Tier 4: intronic/intergenic
rs1205531	X	109296833	G>A,C,T	0.367	intergenic_variant	RNU6-309P - GAPDHP77	2e-10	Tier 4: intronic/intergenic
rs17866912	7	127305741	T>G	0.098	intergenic_variant	PRELID3BP10 - ZNF800	3e-10	Tier 4: intronic/intergenic
rs6860328	5	40729872	T>C	0.424	intron_variant	TTC33	6e-10	Tier 4: intronic/intergenic
rs546238399	5	40790526	C>CTCT,CTCTT,CTCTTT,CTCTTTT,CTCTTTTT,CTCTTTTTT,CTCTTTTTTT,CTCTTTTTTTT,CTCTTTTTTTTT,CTCTTTTTTTTTT,CTCTTTTTTTTTTT,CTCTTTTTTTTTTTT,CTCTTTTTTTTTTTTT,CTCTTTTTTTTTTTTTT,CTCTTTTTTTTTTTTTTTTT	0.387	intron_variant	PRKAA1	9e-10	Tier 4: intronic/intergenic
rs8114689	20	58901835	G>A,C	0.407	intron_variant	GNAS	2e-09	Tier 4: intronic/intergenic
rs6026576	20	58884112	A>C,G,T	0.339	intron_variant	GNAS	2e-09	Tier 4: intronic/intergenic
rs147048677	1	155192003	C>G,T	0.05	synonymous_variant	MUC1	2e-09	Tier 4: intronic/intergenic
chr11:17642804							2e-09	Tier 4: intronic/intergenic
rs4685405	3	16940191	G>A,T	0.458	intron_variant	PLCL2	3e-09	Tier 4: intronic/intergenic

Genes & proteins

No associated-gene cohort resolved for this disease. Atlas builds the molecular and therapeutic sections — associated genes, protein families, druggability, pathways, interactions, and drug associations — by aggregating over a disease’s associated genes (resolved via GWAS / GenCC / ClinVar / CIViC), and none resolved here. This is expected for antibody-mediated, autoimmune, or otherwise non-gene-defined conditions; the curated evidence for this disease is its clinical features, GWAS susceptibility, and clinical trials (above).

Function

No pathway enrichment — requires an associated-gene cohort.

Therapeutics

Drugs indicated for this disease

5 approved, 10 in late-stage (phase 3) trials. Disease-direct ChEMBL indications, not inferred from the associated-gene cohort below.

Drug	Development status
Famotidine	Approved (phase 4)
Lansoprazole	Approved (phase 4)
Misoprostol	Approved (phase 4)
Naproxen	Approved (phase 4)
Omeprazole	Approved (phase 4)
Amoxicillin	Phase 3 (in late-stage trials)
Aspirin	Phase 3 (in late-stage trials)
Bismuth Subcitrate Potassium	Phase 3 (in late-stage trials)
Clarithromycin	Phase 3 (in late-stage trials)
Diclofenac	Phase 3 (in late-stage trials)
Esomeprazole	Phase 3 (in late-stage trials)
Gefarnate	Phase 3 (in late-stage trials)
Ranitidine	Phase 3 (in late-stage trials)
Rebamipide	Phase 3 (in late-stage trials)
Tegoprazan	Phase 3 (in late-stage trials)

Clinical trials & evidence

Clinical trials

Clinical trials: 81.

Phase distribution (across all retrieved trials)

Phase	Trials
PHASE3	29
Not specified	28
PHASE4	11
PHASE1	9
PHASE2	2
PHASE2/PHASE3	1
PHASE1/PHASE2	1

Top trials by phase / activity

NCT	Phase	Status	Title
NCT07312370	PHASE4	NOT_YET_RECRUITING	Esomeprazole Plus Sucralfate for Post-ESD Ulcer Healing
NCT00125736	PHASE4	COMPLETED	A Double-blind, Comparative Study in Patients With Gastric Ulcer to Evaluate the Efficacy of Combination Use of E0671 and Rabeprazole Sodium
NCT00233389	PHASE4	COMPLETED	Post-marketing Clinical Study of Rebamipide in Patients With Gastric Ulcer
NCT00239551	PHASE4	COMPLETED	Effect of Prevacid on Prostaglandin Levels in Patient With Stress Ulcer
NCT00272467	PHASE4	COMPLETED	Healing Effects of Rebamipide and Omeprazole in Helicobacter Pylori-positive Gastric Ulcer After Eradication Therapy
NCT00428701	PHASE4	COMPLETED	An Open-label, Exploratory Trial to Assess Gastric Acid Control in Critically Ill Subjects Receiving Nexium
NCT00839488	PHASE4	TERMINATED	Comparison of Intravenous Pantoprazole and Famotidine for Stress Ulcer Prophylaxis
NCT01190657	PHASE4	COMPLETED	Efficacy and Safety of Teprenone in Patients With Acute Gastritis, Acute Gastric Lesion of Chronic Gastritis With Acute Exacerbation or Gastric Ulcer
NCT03609892	PHASE4	COMPLETED	Helicobacter Rescue Therapy With Berberine Plus Amoxicillin Quadruple Therapy Versus Tetracycline Plus Furazolidone Quadruple Therapy
NCT04885751	PHASE4	UNKNOWN	Compare the Effect of Eupatilin and Rebamipide on the Prevention of Gastroenteropathy
NCT05518929	PHASE4	COMPLETED	Hypoxia During Gastroenterological Endoscope Procedures Sedated With Ciprofol In Overweight Or Obesity Patients
NCT00132171	PHASE3	COMPLETED	Helicobacter Pylori Eradication With a New Sequential Treatment
NCT00149084	PHASE3	UNKNOWN	Tailored Treatment of H. Pylori Infection Based Polymorphisms of CYP2C19 and 23S rRNA of H. Pylori
NCT00153673	PHASE3	COMPLETED	Effect of Selective COX-2 Inhibition on Ulcer Healing
NCT00197418	PHASE2/PHASE3	UNKNOWN	Second Line Therapy for the Cure of Helicobacter Pylori (H. Pylori) Infection
NCT00401752	PHASE3	COMPLETED	Efficacy and Safety Study of Esomeprazole 20mg qd vs Ranitidine 150mg Bid in Patients With an NSAID-induced Gastric Ulcer
NCT00441727	PHASE3	COMPLETED	Study of Esomeprazole 20 mg or 40 mg vs Placebo Effectiveness on the Occurrence of Peptic Ulcers in Subjects on Low Dose Acetylsalicylic Acid (LDA)
NCT00527787	PHASE3	COMPLETED	Evaluating PN 400 (VIMOVO) in Reducing Gastric Ulcers Compared to Non-steroidal Antiinflammatory Drug (NSAID) Naproxen
NCT00527904	PHASE3	COMPLETED	A 12-month, Phase 3, Open-label, Multi-center Study to Evaluate the Long-term Safety of PN400 (VIMOVO)
NCT00542789	PHASE3	COMPLETED	Comparative Efficacy & Safety Study of Esomeprazole Versus Placebo for the Prevention of Gastric and Duodenal Ulcers With NSAID
NCT00594854	PHASE3	TERMINATED	Evaluating PN 400 (VIMOVO) in Reducing Gastric Ulcers in High Risk Subjects Compared to Arthrotec
NCT00595517	PHASE3	COMPLETED	Long Term Study to Investigate the Efficacy & Safety of D961H (Esomeprazole) for the Prevention of NSAIDs-induced Ulcer
NCT00762359	PHASE3	TERMINATED	A Safety and Efficacy Study of Lansoprazole in Preventing Aspirin-Induced Gastric and Duodenal Ulcers
NCT00787254	PHASE3	COMPLETED	Efficacy and Safety of Lansoprazole on Gastric and Duodenal Ulcers in Patients Taking Nonsteroidal Anti-Inflammatory Drugs
NCT00960869	PHASE3	COMPLETED	Study to Evaluate the Incidence of Gastric Ulcers Following Administration of Either PA32540 or Enteric Coated Aspirin 325 mg in Subjects Who Are at Risk for Developing Aspirin-Associated Ulcers
NCT00961350	PHASE3	COMPLETED	A Study to Evaluate the Incidence of Gastric Ulcers Following Administration of Either PA32540 or Enteric Coated Aspirin 325 mg in Subjects Who Are at Risk for Developing Aspirin-Associated Ulcers
NCT01129011	PHASE3	COMPLETED	Evaluating PN 400 (VIMOVO) in Reducing Gastric Ulcers Compared to Non-steroidal Antiinflammatory Drug (NSAID) Naproxen
NCT01150162	PHASE3	COMPLETED	Mucosta in Gastric Ulcer Treatment, Effectiveness and Safety Evaluation
NCT01452711	PHASE3	COMPLETED	Efficacy of TAK-438 Compared to AG-1749 (Lansoprazole) in the Treatment of Gastric Ulcer
NCT01452750	PHASE3	COMPLETED	Efficacy and Safety of TAK-438 for the Prevention of Recurrent Gastric or Duodenal Ulcers During Therapy of Non-steroidal Anti-inflammatory Drug (NSAID)
NCT01452763	PHASE3	COMPLETED	Efficacy and Safety of TAK-438 for the Prevention of Recurrent Gastric or Duodenal Ulcers During Therapy of Low-dose Aspirin
NCT01456247	PHASE3	COMPLETED	Long-term Extension Study of TAK-438 for the Prevention of Recurrent Gastric or Duodenal Ulcers During Therapy of Low-dose Aspirin
NCT01456260	PHASE3	COMPLETED	Long-term Extension Study of TAK-438 for the Prevention of Recurrent Gastric or Duodenal Ulcers During Therapy of Non-steroidal Anti-inflammatory Drug (NSAID)
NCT01568385	PHASE3	COMPLETED	A Unblinded Study of TAK-438 (20 mg) for Prevention of Recurrence of Gastric or Duodenal Ulcer During Long-Term Non-Steroid Anti-Inflammatory Drug (NSAID) Therapy
NCT01568398	PHASE3	COMPLETED	A Unblinded Study of TAK-438 (20 mg) for Prevention of Recurrence of Gastric or Duodenal Ulcer During Long-Term Low-Dose Aspirin Therapy
NCT02153398	PHASE3	COMPLETED	A Phase I/III Study of D961H 10 mg and 20 mg in Japanese Paediatric Patients With Gastrointestinal Acid Related Diseases
NCT02761512	PHASE3	COMPLETED	Study to Evaluate the Safety and Efficacy of CJ-12420 in Patients With Gastric Ulcer
NCT03050307	PHASE3	COMPLETED	Comparison of TAK-438 (Vonoprazan) to Lansoprazole in the Treatment of Gastric Ulcer Participants With or Without Helicobacter Pylori Infection
NCT03553563	PHASE3	COMPLETED	A Study of Esomeplazole (D961H) in Japanese Paediatric Patients With Reflux Esophagitis, Gastric Ulcer or Duodenal Ulcer
NCT05448001	PHASE3	COMPLETED	Clinical Trial to Evaluate the Efficacy and Safety of JP-1366 in Patients With Gastric Ulcer

Drugs tested across these trials (top 30)

Molecule	Max phase	Trials referencing
VONOPRAZAN	4	24
LANSOPRAZOLE	4	11
RABEPRAZOLE	4	4
BERBERINE	4	3
NAPROXEN	4	3
CLARITHROMYCIN	4	2
ESOMEPRAZOLE	4	2
OMEPRAZOLE	4	2
AMOXICILLIN	4	1
DICLOFENAC	4	1
FURAZOLIDONE	4	1
RANITIDINE	4	1
SUCRALFATE	4	1
TETRACYCLINE	4	1
REBAMIPIDE	3	5
CIPEPOFOL	3	2
GEFARNATE	3	2
LAFUTIDINE	3	1
TEPRENONE	3	1
INTERLEUKIN-10	2	1
IRSOGLADINE MALEATE	1	1
CHEMBL1703336	0	5
CHEMBL1618254	0	2
CHEMBL4082704	0	1
CHEMBL1374738	0	1
CHEMBL1572167	0	1
CHEMBL3137673	0	1
CHEMBL2367706	0	1
TNF-ALPHA	0	1
EUPATILIN	-1	1