Endoscopy 2019; 51(04): S245
DOI: 10.1055/s-0039-1681908
ESGE Days 2019 ePosters
Friday, April 5, 2019 09:00 – 17:00: Stomach and small intestine ePosters
Georg Thieme Verlag KG Stuttgart · New York

THE EFFECT OF REBAMIPIDE ON NSAID-INDUCED GASTROENTEROPATHY COMPARED WITH LANSOPRAZOLE: A MULTI-CENTER, RANDOMIZED, OPEN LABELED, PILOT STUDY

DH Lee
1   Seoul National University Bundang Hospital, Internal Medicine, Seongnam, Korea, Republic of
,
JH Cho
1   Seoul National University Bundang Hospital, Internal Medicine, Seongnam, Korea, Republic of
,
H Yoon
1   Seoul National University Bundang Hospital, Internal Medicine, Seongnam, Korea, Republic of
,
CM Shin
1   Seoul National University Bundang Hospital, Internal Medicine, Seongnam, Korea, Republic of
,
YS Park
1   Seoul National University Bundang Hospital, Internal Medicine, Seongnam, Korea, Republic of
,
N Kim
1   Seoul National University Bundang Hospital, Internal Medicine, Seongnam, Korea, Republic of
,
SY Seol
2   Inje University Busan Paik Hospital, Internal Medicine, Busan, Korea, Republic of
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Long-term use of Nonsteroidal anti-inflammatory drugs (NSAIDs) can cause gastroenteropathy. Proton pump inhibitors (PPIs) have been proved to be helpful for NSAID-induced gastroenteropathy and have been widely used. However, the impact of PPIs on small bowel injury induced by NSAIDs is controversial. Rebamipide is also known to be effective against NSAID-induced gastroenteritis, including small intestinal damage, although few studies have been reported in comparison with PPI.

Methods:

This was a multi-center, randomized, open labeled, pilot study. Patients with musculoskeletal disease, such as rheumatoid arthritis and osteoarthritis, who required more than 3 months of NSAIDs were enrolled, and all these patients were treated with meloxicam. The study group received rebamipide three times daily, and the control group received lansoprazole one time daily. Esophagastroduodenoscopy, capsule endoscopy, laboratory test, and gastrointestinal symptoms were measured before and 12 weeks after.

Results:

A total of 33 patients were included with 15 in the study group and 18 in the control group. NSAID-induced gastric ulcer, which was the primary outcome of this study, did not occur in both groups. The change in the number of small bowel erosions and ulcers was -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 3 (20%) in the study group and 6 (40%) in the control group (p= 0.427). No serious adverse events occurred in both groups. but, adverse events such as dyspepsia and skin rash occurred in 6 (32%) in the study group and 13 (65%) in the control group (p= 0.036).

Conclusions:

There was a trend that rebamipide decreased NSAID-induced mucosal damage compared to PPI, although there was no statistical difference. Moreover, rebamipide had fewer adverse effects than lansoprazole.