Effect of rebamipide on gastric ulcer healing caused by Helicobacter pylori and/or NSAIDs or non NSAIDs-non H. pylori

Abstract

Background: Rebamipide, a gastro-protective drug, acts on stimulation of prostaglandin and mucus glycoprotein synthesis, inhibition of reactive oxygen species, inflammatory cytokines, and neutrophils activation.

Objective: To investigate the effect of rebamipide (mucosta) on healing of gastric ulcer caused by various etiologies.

Material and method: Thirty patients with gastric ulcer underwent gastric antral and body biopsies for histopathology. Group classifications depended on H. pylori status using CLO test, histology or urea breath test and history ofNSAIDs taking. All patients received rebamipide 100 mg, three times a day, for 8 weeks. The symptoms and adverse effects were assessed in 4 weeks and 8 weeks after prescription. At the end of the present study, an endoscopy was repeated to evaluate ulcer healing and biopsy for gastric inflammation grading.

Results: According to the ulcer cause, there were seven patients with H. pylori+ NSAIDs+, nine patients with H. pylori + NSAIDs-, three patients with H. pylori - NSAIDs +, and 11 patients with H. pylori - NSAIDs-. The ulcers were completely healed in most patients with a history of NSAIDs use. There was a significant improvement of symptom scores from baseline in all groups (5.9 vs. 0.6, p < 0.001). The improvement of gastric inflammation scores were favorable in NSAIDs users (2.38 vs. 1.75, p = 0.011). All patients were satisfied as there were few adverse effects.

Conclusion: Rebamipide is effective and well tolerated for treatment of gastric ulcers especially those caused by NSAIDs, as it promotes the improvement of gastric inflammation scores, clinical symptoms, and ulcer healing.