Rebamipide in gastric mucosal protection and healing: An Asian perspective

Table 1 Efficacy and safety of rebamipide (alone or in combination) vs other drugs/treatment combinations used for the treatment of different gastrointestinal conditions

Condition	Comparison	Outcome	Adverse events	Ref.
H. pylori infection	Eradication therapy + rebamipide vs eradication therapy-rebamipide. Rebamipide after eradication therapy vs placebo after eradication therapy	Addition of rebamipide enhanced the effectiveness of H. pylori eradication treatment. Gastric ulcer healing after the eradication therapy was higher in the rebamipide group	No significant differences in AEs reported between the + rebamipide and rebamipide groups. The 55.2% reported AEs (diarrhea and abnormal taste sensation) in the rebamipide group and 51.7% reported AEs in the placebo group	Andreev et al[33], 2019. Andreev et al[39], 2018. Nishizawa et al[40], 2014
Post-endoscopic sub-mucosal dissection ulcers	Rebamipide vs misoprostol	The occurrence rate of gastric ulcers was lower in the rebamipide group compared with the misoprostol group	Total severity score of GI symptoms and use of antacid were significantly lower in the rebamipide group than the misoprostol group	Kim et al[41], 2014
	2% rebamipide solution vs saline solution	Healing score was significantly higher in the rebamipide group	No AEs reported	Fujimoto et al[42], 2018
	Vonoprazan + rebamipide vs esomeprazole + rebamipide	Ulcer scar rates at week 4 were comparable across both groups	No AEs reported	Ichida et al[43], 2019
	Polaprezinc + pantoprazole vs rebamipide + pantoprazole	Ulcer healing rates were comparable across both groups	No AEs reported	Jung DH et al[48], 2021
	Pantoprazole/lansoprazole + rebamipide vs placebo	Ulcer reduction rate was higher for the pantoprazole/lansoprazole + rebamipide group	No AEs reported	Yan et al[44], 2019
Non-steroidal anti-inflammatory drug induced gastroenteropathy	Rebamipide + meloxicam vs lansoprazole + meloxicam	Fewer mucosal breaks were reported in the rebamipide + meloxicam group	Significantly fewer AEs were reported in the rebamipide + meloxicam group (31.5%) vs the lansoprazole + meloxicam group (65%)	Oh et al[45], 2022
Gastroesophageal reflux disease	Rebamipide + esomeprazole/lansoprazole vs esomeprazole/lansoprazole	Reductions in reflux symptoms were higher in the rebamipide group	No AEs reported	Bakulina et al[11], 2023
Gastritis	Rebamipide vs sucralfate	Reductions in GI symptoms (abdominal pain, belching, and acid reflux) and gastric mucosal inflammation were more apparent in the rebamipide group than in the sucralfate group	Rebamipide was associated with fewer AEs (specifically diarrhea)	Du et al[46], 2008
GI hemorrhage	Rabeprazole + rebamipide vs rabeprazole	Lower incidence of GI hemorrhage was noted in the rebamipide group	No significant differences seen in the occurrence of major adverse cardiac events	Jia et al[47], 2022
Ulcerative colitis	Rebamipide micro-enemas	Complete remission: 45%. Significant improvement: 18.2%. Slight improvement: 27.3%	No side effects reported	Tarnawski et al[27], 2004

AEs: Adverse effects; GI: Gastrointestinal; H. pylori: Helicobacter pylori.