Effect of Rebamipide on Gastric Ulcer Healing Caused by Helicobacter pylori and/or NSAIDs or Non NSAIDs-Non H. pylori
Duangporn Thong-Ngam MD*, Maneerat Chayanupatkul MD*, Naruemon Klaikeaw MD**, Rungsun Rerknimitr MD***, Varocha Mahachai MD***
Affiliation : * Department of Physiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand ** Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand *** GI Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Background : Rebamipide, a gastro-protective drug, acts on stimulation of prostaglandin and mucus glyco-
protein 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 of NSAIDs 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.
Keywords : Rebamipide, NSAIDs, Non-steroidal anti-inflammatory agents, Helicobacter pylori, Symptoms score, Gastric inflammation
