Preventive Effects of Rebamipide on NSAID-Induced Gastric Mucosal Injury and Reduction of Gastric Mucosal Blood Flow in Healthy Volunteers

Abstract

The precise mechanisms of acute damage and the role of gastric mucosal blood flow in gastric mucosal injury induced by nonsteroidal anti-inflammatory drugs (NSAIDs) remain uncertain. The aim of this study was to evaluate the preventive effect of rebamipide on gastric mucosal injury and reduction of gastric mucosal blood flow (GMBF) after ibuprofen administration. Twenty healthy volunteers were randomized two groups. The rebamipide group took ibuprofen, 1800 mg/day, and rebamipide, 100 mg t.i.d., for 7 days. The placebo group took ibuprofen, 1800 mg/day. The numbers of gastric ulcer subjects were three in the placebo group and zero in the rebamipide group. The mean modified Lanza score after ibuprofen administration was significantly higher in the placebo group than the rebamipide group (2.9+/-1.7 vs. 1.3+/-1.0, respectively; P=0.032). The GMBF of the placebo group was significantly decreased at antrum from baseline, from 2.8+/-0.5 to 2.0+/-0.5 tissue perfusion units (P=0.005). There was no difference in GMBF change in the rebamipide group. Gastric mucosal injury was correlated with GMBF reduction in antrum (r=-0.677, P=0.001). In conclusion, it is suggested that the decrease in GMBF may have been associated with NSAID-induced gastric mucosal injury, and rebamipide may have prevented NSIAD-induced gastric mucosal injury by maintaining GMBF in healthy subjects.

Contributing Factors to Gastric Ulcer Healing After Endoscopic Submucosal Dissection Including the Promoting Effect of Rebamipide

“…Rebamipide is a well-known antiulcer drug that has many biological activities in the gastric The basal healing rate of the combination group was significantly greater than that of the PPI group for large-sized ulcers, but there were no significant differences for normal-sized ulcers (b). Combination, PPI plus rebamipide; normal-size, ulcer area \1,200 mm 2 ; large-size, ulcer area C1,200 mm 2 ; NS not significant mucosa, such as stimulating angiogenesis by activating pro-angiogenic growth factors [14], increasing the biosynthesis of endogenous prostaglandins [15], and inhibiting neutrophils activated by H. pylori [16,17] and non-steroidal anti-inflammatory drugs [18,19]. Iijima et al [20] also reported that rebamipide administration increased gastric mucus secretion in humans.…”

Rebamipide has the potential to reduce the intensity of NSAID-induced small intestinal injury: a double-blind, randomized, controlled trial evaluated by capsule endoscopy

“…Nevertheless, this study has been able to show that rebamipide might be effective at preventing NSAIDinduced small intestinal injuries to a certain extent. Rebamipide has been used across Asia for the treatment of gastric ulcers and gastric lesions such as erosions and edema caused by acute gastritis [14,17,22]. It has been well documented that rebamipide increases endogenous prostaglandin levels, scavenges free radicals, and suppresses inflammation in the gastric mucosa [23][24][25].…”

Efficacy and Safety of Rebamipide in Prevention of NSAID-Gastropathy

“…[8] In the study by Kіm et al, [9] twenty healthy volunteers were randomized two groups. The placebo group took ibuprofen, 600 mg t.i.d., and placebo for 7 days.…”