Efficiency of the Inclusion of Rebamipide in the Eradication Therapy for Helicobacter pylori Infection: Meta-Analysis of Randomized Controlled Studies

Abstract

Background: There has been a negative trend in the effectiveness of classic eradication therapy regimens for Helicobacter pylori (H. pylori), which has largely been determined from the emergence and spread of antibiotic resistance. Several studies have shown that adding rebamipide to eradication regimens leads to an increase in the effectiveness of treatment. Aim: To evaluate the efficacy and safety of including rebamipide in the eradication regimens for H. pylori infection. Methods: The literature search was conducted in the MEDLINE/PubMed, EMBASE, Cochrane Central Register, Korean Medical Citation Index, and Russian Science Citation Index databases. All identified randomized controlled trials comparing rebamipide supplementation with non-rebamipide-containing eradication regimens for the treatment of H. pylori infection were included in the final analysis. Results: We identified 11 randomized controlled trials (RCTs) involving 1227 patients (631 in groups with rebamipide and 596 in groups without rebamipide). The meta-analysis showed that the addition of rebamipide to eradication regimens significantly increased the effectiveness of treatment (odds ratio (OR) 1.753, 95% confidence interval (CI) 1.312–2.333, p < 0.001). The subgroup analysis demonstrated that rebamipide significantly increased the effectiveness of eradication when added to a dual therapy regimen (OR 1.766, 95% CI: 1.167–2.495, p = 0.006); however, no significant improvement in effectiveness was observed when it was added to the triple therapy regimen (OR 1.638, 95% CI 0.833–3.219, p = 0.152). Conclusion: This meta-analysis demonstrated that the addition of rebamipide to H. pylori eradication regimens significantly increases the effectiveness of treatment.

Diagnosis and Treatment of Peptic Ulcer in Adults (Clinical Guidelines of the Russian Gastroenterological Association, Russian Society of Colorectal Surgeons and the Russian Endoscopic Society)

“…• Пациентам с ЯБ, инфицированным H. pylori, с целью повышения эффективности эрадикационной терапии рекомендуется добавление в схемы эрадикации рабамипида [33,34].…”

“…Комментарии: 2 проведенных метаанализа, включавших 6 и 11 рандомизированных контролируемых исследований, подтвердили повышение частоты эрадикации при включении в ее схемы ребамипида [33,34].…”

Management of patients with digestive diseases during the COVID-19 pandemic: Clinical Practice Guidelines by the Gastroenterological Scientific Society of Russia

“…Важным эффектом ребамипида является свойство снижать адгезию патогенных бактерий, включая Helicobacter pylori, к СО ЖКТ, что повышает эффективность эрадикационной терапии [33,41,42,43,44].…”

European Registry on the management of Helicobacter pylori infection: features of diagnosis and treatment in Kazan

“…Помимо этого, последние рекомендации РГА допускают использование цитопротектора -ребамипида при применении тройной терапии для повышения уровня эрадикации микроорганизма [37,38]. Эффективность такого подхода подтверждена недавним метаанализом [39].…”