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Efficacy of treatment with rebamipide for endoscopic submucosal dissection-induced ulcers.

AbstractAIM:
To prospectively compare the healing rates of endoscopic submucosal dissection (ESD)-induced ulcers treated with either a proton-pump inhibitor (PPI) or rebamipide.
METHODS:
We examined 90 patients with early gastric cancer who had undergone ESD. All patients were administered an intravenous infusion of the PPI lansoprazole (20 mg) every 12 h for 2 d, followed by oral administration of lansoprazole (30 mg/d, 5 d). After 7-d treatment, the patients were randomly assigned to 2 groups and received either lansoprazole (30 mg/d orally, n = 45; PPI group) or rebamipide (300 mg orally, three times a day; n = 45; rebamipide group). At 4 and 8 wk after ESD, the ulcer outcomes in the 2 groups were compared.
RESULTS:
No significant differences were noted in patient age, underlying disease, tumor location, Helicobacter pylori infection rate, or ESD-induced ulcer size between the 2 groups. At both 4 and 8 wk, the healing rates of ESD-induced ulcers were similar in the PPI-treated and the rebamipide-treated patients (4 wk: PPI, 27.2%; rebamipide, 33.3%; P = 0.5341; 8 wk: PPI, 90.9%; rebamipide, 93.3%; P = 0.6710). At 8 wk, the rates of granulation lesions following ulcer healing were significantly higher in the PPI-treated group (13.6%) than in the rebamipide-treated group (0.0%; P = 0.0103). Ulcer-related symptoms were similar in the 2 treatment groups at 8 wk. The medication cost of 8-wk treatment with the PPI was 10945 yen vs 4889 yen for rebamipide. No ulcer bleeding or complications due to the drugs were observed in either treatment group.
CONCLUSION:
The healing rate of ESD-induced ulcers was similar with rebamipide or PPI treatment; however, rebamipide treatment is more cost-effective and prevents granulation lesions following ulcer healing.
AuthorsMasaki Takayama, Shigenaga Matsui, Masanori Kawasaki, Yutaka Asakuma, Toshiharu Sakurai, Hiroshi Kashida, Masatoshi Kudo
JournalWorld journal of gastroenterology (World J Gastroenterol) Vol. 19 Issue 34 Pg. 5706-12 (Sep 14 2013) ISSN: 2219-2840 [Electronic] United States
PMID24039365 (Publication Type: Journal Article, Randomized Controlled Trial)
Chemical References
  • Anti-Ulcer Agents
  • Proton Pump Inhibitors
  • Quinolones
  • Lansoprazole
  • rebamipide
  • Alanine
Topics
  • Adenocarcinoma (surgery)
  • Aged
  • Alanine (analogs & derivatives, therapeutic use)
  • Anti-Ulcer Agents (therapeutic use)
  • Dissection (adverse effects)
  • Female
  • Gastroscopy (adverse effects)
  • Humans
  • Iatrogenic Disease
  • Lansoprazole (therapeutic use)
  • Male
  • Middle Aged
  • Peptic Ulcer (drug therapy, etiology)
  • Prospective Studies
  • Proton Pump Inhibitors (therapeutic use)
  • Quinolones (therapeutic use)
  • Stomach Neoplasms (surgery)

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