Assessing the efficacy of famotidine and rebamipide in the treatment of gastric mucosal lesions in patients receiving long-term NSAID therapy (FORCE—famotidine or rebamipide in comparison by endoscopy)

Yamao, Junichi; Kikuchi, Eiryo; Matsumoto, Masami; Nakayama, Masaki; Ann, Tatsuichi; Kojima, Hideyuki; Mitoro, Akira; Yoshida, Motoyuki; Yoshikawa, Motokiyo; Yajima, Hiroshi; Miyauchi, Yoshimasa; Ono, Hiroshi; Akiyama, Koichi; Sakurai, Goro; Kinoshita, Yoshikazu; Haruma, Ken; Takakura, Yoshinori; Fukui, Hiroshi

doi:10.1007/s00535-006-1952-5

Cited by 23 publications

(11 citation statements)

References 20 publications

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“…In this study, we examined RA patients selected from the population of the FORCE study but found that the risk factors and prevalence of gastric mucosal injury, and also the efficacy of famotidine (20 mg/day), were similar to the respective results obtained for the entire FORCE study population [9,10]. Our results suggest that treatment with famotidine (20 mg/day) is effective even in RA patients, who are often administered steroids or DMARDs concomitantly with NSAIDs.…”

Section: Discussionsupporting

confidence: 66%

“…The study has already been published in detail elsewhere [9,10]. For this report, we selected 100 RA patients from the FORCE study population and examined the prevalence of gastric mucosal injury in RA patients receiving long-term NSAID therapy to identify patient factors contributing to the development of such mucosal injury and compare the effects of famotidine and rebamipide in the treatment of NSAID-induced gastric mucosal injury of RA patients.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for the development of gastric mucosal lesions in rheumatoid arthritis patients receiving long-term nonsteroidal anti-inflammatory drug therapy and the efficacy of famotidine obtained from the FORCE study

et al. 2009

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The objective of this study was to investigate the prevalence of gastric mucosal injury induced by nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with rheumatoid arthritis (RA). Upper gastrointestinal endoscopy was performed on 100 RA patients treated with NSAIDs. Patient factors potentially contributing to the development of NSAID-induced gastric mucosal injury were identified by logistic regression analysis; gastric mucosal injury and ulcers were used as objective variables. Gastric mucosal injury was detected in 62 of 100 patients, and eight of these patients had ulcers. Previous history of ulcers, lifestyle, NSAID dosage, and body mass index were associated with the development of gastric mucosal injury,and the use of diclofenac and steroid dose were associated with the development of ulcers. Disease-modifying antirheumatic drugs (DMARDs) did not appear to influence the risk of NSAID-induced gastric mucosal injury. RA patients treated for long periods with NSAIDs for RA symptoms should be controlled with DMARDs, without consideration of increased doses of steroids, in terms of risk for NSAID-induced gastric mucosal injury. Simultaneously, concomitant use of histamine-2 receptor antagonists (H2RA) such as famotidine should be considered.

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Section: Discussionsupporting

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Risk factors for the development of gastric mucosal lesions in rheumatoid arthritis patients receiving long-term nonsteroidal anti-inflammatory drug therapy and the efficacy of famotidine obtained from the FORCE study

et al. 2009

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“…23 It also prevented peptic ulcers as effectively as misoprostol and famotidine in patients on long-term NSAIDs treatment. 24,25 Mizoguchi et al 16 suggested that rebamipide is effi cacious in preventing NSAID-induced small-intestinal lesions in rats. These basic and clinical data regarding NSAIDinduced gastrointestinal injury suggest that rebamipide has a preventive effect for intestinal events.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of rebamipide for diclofenac-induced small-intestinal mucosal injuries in healthy subjects: a prospective, randomized, double-blinded, placebo-controlled, cross-over study

et al. 2008

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“…Yamao et al 8 compared the effects of famotidine (a H 2 -receptor antagonist) and rebamipide (a gastric mucosal defensive drug) on NSAID-associated gastric mucosal lesions using upper gastrointestinal endoscopy in Japan, and famotidine was superior to rebamipide in treating NSAID-associated mucosal lesions.…”

Section: Relationship Between Nsaids Ulcer and H Pylori Infectionmentioning

confidence: 98%

Helicobacter pylori and NSAID-induced gastric ulcer in a Japanese population

et al. 2009

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A recent meta-analysis by Huang et al. clarified that Helicobacter pylori infection and nonsteroidal antiinflammatory drugs (NSAIDs) are important factors for peptic ulcer. The results showed that the risk for ulcer in NSAID(+)/H. pylori(+) patients was 61.1 fold higher when compared with NSAID(-)/H. pylori(-) patients. Some gastric ulcers detected in patients on NSAID therapy may actually be caused by H. pylori, but it is difficult to differentiate NSAID-induced gastric ulcer from H. pylori-induced gastric ulcer. Several studies have investigated the effects of H. pylori eradication on ulcer healing. One study reported that H. pylori eradication actually lowered the healing rate of gastric ulcers. Because there have been no studies finding that H. pylori eradication facilitates healing, H. pylori eradication is not recommended for NSAID users. Concerning the efficacy of H. pylori eradication in the prevention of NSAID-induced gastric ulcer, a meta-analysis concluded that among all patients on NSAID therapy, H. pylori eradication lowered the prevalence of ulcer, which was particularly marked in NSAID-naïve patients. When compared with those of proton pump inhibitors (PPIs), the preventative effects of H. pylori eradication were inferior. In Japan, national health insurance does not cover procedures that prevent or lower the risk for NSAID-induced ulcer. When administering NSAID to patients with risk factors, it is desirable to administer antiulcer agents.

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Assessing the efficacy of famotidine and rebamipide in the treatment of gastric mucosal lesions in patients receiving long-term NSAID therapy (FORCE—famotidine or rebamipide in comparison by endoscopy)

Abstract: Famotidine was superior to rebamipide in treating NSAID-associated mucosal lesions.

Cited by 23 publications

References 20 publications

Risk factors for the development of gastric mucosal lesions in rheumatoid arthritis patients receiving long-term nonsteroidal anti-inflammatory drug therapy and the efficacy of famotidine obtained from the FORCE study

Risk factors for the development of gastric mucosal lesions in rheumatoid arthritis patients receiving long-term nonsteroidal anti-inflammatory drug therapy and the efficacy of famotidine obtained from the FORCE study

Efficacy of rebamipide for diclofenac-induced small-intestinal mucosal injuries in healthy subjects: a prospective, randomized, double-blinded, placebo-controlled, cross-over study

Helicobacter pylori and NSAID-induced gastric ulcer in a Japanese population

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