Rebamipide for the Improvement of Gastric Atrophy and Intestinal Metaplasia: A Prospective, Randomized, Pilot Study

• Published in: Digestive diseases and sciences 2022-06, Vol.67 (6), p.2395-2402
• Main Authors: Lee, Joon Seop, Jeon, Seong Woo, Lee, Hyun Seok, Kwon, Yong Hwan, Nam, Su Youn, Bae, Han Ik, Seo, An Na
• Format: Article
• Language: English
• Subjects: Alanine - analogs & derivatives; Analysis; Atrophy; Biochemistry; Disease; Dysplasia; Endoscopy; Gastric cancer; Gastric Mucosa - pathology; Gastritis, Atrophic - complications; Gastroenterology; Health aspects; Helicobacter Infections - complications; Helicobacter Infections - drug therapy; Helicobacter Infections - epidemiology; Helicobacter pylori; Hepatology; Hospitals; Humans; Infections; Informed consent; Medicine; Medicine & Public Health; Metaplasia - pathology; Neutrophils; Nonsteroidal anti-inflammatory drugs; Oncology; Original Article; Pilot Projects; Prospective Studies; Quinolones; Stomach cancer; Stomach Neoplasms - complications; Substance abuse treatment; Transplant Surgery; Ulcers
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-021-07038-7

Background The presence of atrophic gastritis (AG) and intestinal metaplasia (IM) is associated with an increased risk of gastric cancer (GC). Thus, the development of new strategies to improve AG/IM is essential for reducing the incidence of GC. Aims We aimed to evaluate the efficacy of rebamipide for improving AG/IM. Methods This was a prospective, randomized, pilot study from a single tertiary referral center. Fifty-three (rebamipide, n  = 34 vs. placebo, n  = 19) patients, who underwent endoscopic resection for gastric dysplasia or early GC, were analyzed. We obtained tissue samples from the antrum and corpus of the stomach, at the time of screening and 1-year later. The histologic grading of inflammation was performed by histopathologists Results The AG grade in the antrum improved significantly after rebamipide treatment (pre-administration, 1.870 ± 0.932 vs. post-administration, 1.430 ± 0.986; P  = 0.013). Additionally, the severity of IM in the antrum was significantly improved (pre-administration, 1.750 ± 0.963 vs. post-administration, 1.370 ± 1.032; P  = 0.038). The rebamipide subgroup analysis revealed that patients with no Helicobacter pylori (HP) infection showed significant improvements in AG in the antrum (pre-administration, 1.880 ± 1.040 vs. post-administration, 1.250 ± 0.894; P  = 0.028) and IM in antrum (pre-administration, 1.840 ± 1.012 vs. post-administration, 1.180 ± 0.912; P  = 0.020). Conclusions This study demonstrated that the administration of rebamipide improves AG and IM in the antrum, especially in patients with HP non-infection (KCT0001915).