Rebamipide with Proton Pump Inhibitors (PPIs) versus PPIs Alone for the Treatment of Endoscopic Submucosal Dissection-Induced Ulcers: A Meta-analysis.

Abstract

OBJECTIVE:

To contrast the effect of rebamipide with proton pump inhibitors (PPIs) versus PPIs alone for the treatment of endoscopic submucosal dissection (ESD-) induced ulcers.

METHODS:

PubMed, Embase, the Cochrane library, the WanFang database, and China National Knowledge Infrastructure (CNKI) were searched to identify studies that met the inclusion criteria.

RESULTS:

Nine randomized controlled trials (RCTs) were recognized, including 1170 patients. In general, rebamipide plus PPIs acted better than PPIs alone against ESD-induced ulcers at four weeks (RR = 1.42, 95% CI: 1.13-1.78, P = 0.003) but showed no significant differences at eight weeks (RR = 1.03, 95% CI: 0.97-1.10, P = 0.315). The use of rebamipide plus PPIs was superior to PPIs alone for ESD-induced ulcers greater than 20 mm in size (20-40 mm: RR = 1.98, 95% CI: 1.22-3.23, P = 0.006; >40 mm: RR = 5.14, 95% CI: 1.49-17.74, P = 0.010). In addition, rebamipide plus PPI therapy was discovered to be significantly more effective than PPIs alone for lower ESD-induced ulcers (RR = 1.82, 95% CI: 1.04-3.20, P = 0.037). There were no significant differences between the treatment groups with the ulcer reduction rate.

CONCLUSION:

Evidences now available show rebamipide plus PPIs is practical for protecting against ESD-induced ulcers at four weeks but not at eight weeks, especially large ulcers (>20 mm). However, we still need more high-quality RCTs in the future to supplement our conclusions.

• Authors: Junyuan Liu, Zhencheng Xiong, Xuhua Geng, Meihua Cui
• Journal: BioMed research international (Biomed Res Int) Vol. 2020 Pg. 7196782 ( 2020) ISSN: 2314-6141 [Electronic] United States
• PMID: 33062694 (Publication Type: Journal Article, Meta-Analysis)
• Copyright: Copyright © 2020 Junyuan Liu et al.

Chemical References

• Anti-Ulcer Agents
• Proton Pump Inhibitors
• Quinolones
• rebamipide
• Alanine

Topics

• Alanine (analogs & derivatives, therapeutic use)
• Anti-Ulcer Agents (therapeutic use)
• Endoscopic Mucosal Resection (adverse effects)
• Female
• Humans
• Male
• Middle Aged
• Proton Pump Inhibitors (therapeutic use)
• Quinolones (therapeutic use)
• Stomach Ulcer (drug therapy, etiology)