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Randomized Controlled Trial
. 2022 Nov;37(6):1153-1166.
doi: 10.3904/kjim.2021.216. Epub 2022 Nov 1.

The effect of rebamipide on non-steroidal anti-inflammatory drug-induced gastro-enteropathy: a multi-center, randomized pilot study

Dong Jun Oh  1 , Hyuk Yoon  1 , Hyun Soo Kim  1 , Yoon Jin Choi  1 , Cheol Min Shin  1 , Young Soo Park  1 , Nayoung Kim  1   2 , Dong Ho Lee  1   2 , You-Jung Ha  1 , Eun Ha Kang  1 , Yun Jong Lee  1   2 , Nayoung Kim  2 , Ki-Jeoung Kim  1 , Fei Liu  3
Affiliations
Randomized Controlled Trial

The effect of rebamipide on non-steroidal anti-inflammatory drug-induced gastro-enteropathy: a multi-center, randomized pilot study

Dong Jun Oh et al. Korean J Intern Med. 2022 Nov.

Abstract

Background/aims: Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly-used medications, and ailments such as arthritis or heart disease, require long-term use of these drugs, which can induce gastroenteropathy with bleeding and ulcers. This study investigated the associations between efficacy, safety, and gastrointestinal symptoms linked to rebamipide and proton pump inhibitor administration in patients requiring long-term NSAID use.

Methods: This study was a multi-center, randomized, open-labeled, pilot design.

Results: Thirty-three patients were included. Of these, 15 were included in the study group and 18 were in the control group. NSAID-induced gastric ulcers, which were the primary outcome of this study, did not occur in either the study or control group. Changes in the number of small bowel erosions and ulcers were -0.6 ± 3.06 in the study group and 1.33 ± 4.71 in the control group. The number of subjects with mucosal breaks (defined as multiple erosions and/or ulcers) was three (20%) in the study group and six (40%) in the control group (p = 0.427). No serious adverse events occurred in either group. However, dyspepsia and skin rashes occurred in six patients (31.58%) in the study group and 13 (65%) in the control group (p = 0.036).

Conclusion: Although statistically significant differences were not generated, possibly as a result of the small sample size, mucosal breaks observed via capsule endoscopy revealed that rebamipide was likely to be more effective than lansoprazole in preventing small intestine damage caused by NSAIDs. Furthermore, fewer side-effects emerged with rebamipide.

Keywords: Anti-inflammatory agents, non-steroidal; Gastrointestinal diseases; Proton pump inhibitors; Rebamipide; Small bowel injury.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1
Schema of this study’s protocol. Visit 1 (V1), visit 2 (V2), visit 3 (V3), visit 4 (V4), visit 5 (V5).
Figure 2
Figure 2
Small bowel erosion (A) and ulcer (B) in control group after administration of non-steroidal anti-inflammatory drugs.
None
See this image and copyright information in PMC

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