Journal of Gastroenterology

, Volume 41, Issue 12, pp 1178–1185 | Cite as

Assessing the efficacy of famotidine and rebamipide in the treatment of gastric mucosal lesions in patients receiving long-term NSAID therapy (FORCE—famotidine or rebamipide in comparison by endoscopy)

  • Jun-ichi Yamao
  • Eiryo Kikuchi
  • Masami Matsumoto
  • Masaki Nakayama
  • Tatsuichi Ann
  • Hideyuki Kojima
  • Akira Mitoro
  • Motoyuki Yoshida
  • Masaaki Yoshikawa
  • Hiroshi Yajima
  • Yoshizumi Miyauchi
  • Hiroshi Ono
  • Koichi Akiyama
  • Goro Sakurai
  • Yoshikazu Kinoshita
  • Ken Haruma
  • Yoshinori Takakura
  • Hiroshi Fukui
Article

Abstract

Background

Nonsteroidal anti-inflammatory drugs (NSAIDs) and Helicobacter pylori infection are major causes of gastric mucosal lesions. In Japan, histamine-2 receptor antagonists are frequently prescribed, but the literature regarding their efficacy is limited. In this study, we compare the effects of famotidine and rebamipide on NSAID-associated gastric mucosal lesions using upper gastrointestinal endoscopy.

Methods

This study examined 112 patients taking NSAIDs for either gastric hemorrhage or erosion. Before treat-ment, the patients were assessed by endoscopy. Using blind randomization, patients were divided into two groups: group F (famotidine, 20 mg/day) and group R (rebamipide, 300 mg/day). Efficacy was examined 4 weeks later using endoscopy.

Results

After treatment, the Lanza score decreased significantly in group F (P < 0.001) but not in group R (P = 0.478). The change in the Lanza score in group F was significantly greater (P = 0.002) than that in group R.

Conclusions

Famotidine was superior to rebamipide in treating NSAID-associated mucosal lesions.

Key words

famotidine rebamipide randomized study mucosal lesion NSAID 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Research Team for the Development of Guidelines for Evidence-Based Gastric Ulcer Diagnosis, Guideline for Clinical Practice of Gastric Ulcer Based on EBM (in Japanese with English abstract). Jiho 2003;7–14Google Scholar
  2. 2.
    Huang, JQ, Sridhar, S, Hunt, RH 2002Role of Helicobacter pylori infection and non-steroidal anti-inflammatory drugs in peptic-ulcer disease: a meta-analysisLancet3591422PubMedCrossRefGoogle Scholar
  3. 3.
    Asaka, M, Satoh, K, Sugano, K, Sugiyama, T, Takahashi, S, Shimoyama, T,  et al. 2001Guidelines in the management of Helicobacter pylori infection In JapanHelicobacter617786PubMedCrossRefGoogle Scholar
  4. 4.
    Miwa, H, Sakaki, N, Sugano, K, Sekine, H, Higucni, K, Sugiyama, T,  et al. 2004Recurrent peptic ulcers in patients following successful Helicobacter pylori eradication: a multicenter study of 4940 patientsHelicobacter9926PubMedCrossRefGoogle Scholar
  5. 5.
    Robert, A 1976Antisecretory anti-ulcer, cytoprotective and diarrheogenic properties of prostaglandinsAdv Prostaglandin Thromboxane Res250720PubMedGoogle Scholar
  6. 6.
    Ligumsky, M, Golanska, EM, Hansen, DG, Kauffman, GL 1983Aspirin can inhibit gastric mucosal cyclo-oxygenase without causing lesions in ratGastroenterology8475661PubMedGoogle Scholar
  7. 7.
    Frezza, M, Gorji, N, Melato, M 2001The histopathology of non-steroidal anti-inflammatory drug induced gastroduodenal damage: correlation with Helicobacter pylori, ulcers, and hemorrhagic eventsJ Clin Pathol545215PubMedCrossRefGoogle Scholar
  8. 8.
    Funatsu, T, Chono, K, Hirata, T, Keto, Y, Kimoto, A, Sasamata, M 2004The possible role of gastric acid against non-steroidal anti-inflammatory drugs-induced gastric microcirculatory disturbance in ratsJpn Pharmacol Ther3242934Google Scholar
  9. 9.
    Taha, AS, Hudson, N, Hawkey, CJ, Swannell, AJ, Trye, PE, Cottrell, J,  et al. 1996Famotidine for the prevention of gastric and duodenal ulcers caused by nonsteroidal antiinflammatory drugsN Engl J Med33414359PubMedCrossRefGoogle Scholar
  10. 10.
    Hudson, N, Taha, AS, Russell, RI, Trye, P, Cottrell, J, Mann, SG,  et al. 1997Famotidine for healing and maintenance in nonsteroidal anti-inflammatory drug-associated gastroduodenal ulcerationGastroenterology112181722PubMedCrossRefGoogle Scholar
  11. 11.
    Keto, Y, Funatsu, T, Hirata, T, Toyama, T, Sudoh, K, Sasamata, M 2003Inhibitory effects of famotidine on NSAIDs and bisphosphonate-induced mucosal lesions in ratsJpn Pharmacol Ther3148593Google Scholar
  12. 12.
    Raskin, JB, White, RH, Jackson, JE, Weaver, AL, Tindall, EA, Leis, RB,  et al. 1991Misoprostol dosage in the prevention of nonsteroidal anti-inflammatory drug-induced gastric and duodenal ulcers: a comparison of three regimensAnn Intern Med115195200Google Scholar
  13. 13.
    Agrawal, NM, Van Kerckhove, HE, Erhardt, LJ, Geis, GS 1995Misoprostol coadministered with diclofenac for prevention of gastroduodenal ulcers. A one-year studyDig Dis Sci40112531PubMedCrossRefGoogle Scholar
  14. 14.
    Bocanegra, TS, Weaver, AL, Tindall, EA, Sikes, DH, Ball, JA, Wallemark, CB,  et al. 1998Diclofenac/misoprostol compared with diclofenac in the treatment of osteoarthritis of the knee or hip: a randomized, placebo controlled trial. Arthrotec Osteoarthritis Study GroupJ Rheumatol25160211PubMedGoogle Scholar
  15. 15.
    Walt, RP 1992Misoprostol for the treatment of peptic ulcer and antiinflammatory-drug-induced gastroduodenal ulcerationN Engl J Med327157580PubMedCrossRefGoogle Scholar
  16. 16.
    Katsuragi, K, Noda, A, Tachikawa, T, Azuma, A, Mukai, F, Murakami, K,  et al. 1998Highly sensitive urine-based enzyme-linked immunosorbent assay for detection of antibody to Helicobacter pyloriHelicobacter328995PubMedCrossRefGoogle Scholar
  17. 17.
    Kato, M, Asaka, M, Saito, M, Sekine, H, Ohara, S, Toyota, T,  et al. 2000Clinical usefulness of urine-based enzyme-linked immunosorbent assay for detection of antibody to Helicobacter pylori: a collaborative study in nine medical institutions in JapanHelicobacter510919PubMedCrossRefGoogle Scholar
  18. 18.
    Lanza, FL, Royer, GL, Nelson, RS, Chen, TT, Seckman, CE, Rack, MF 1981A comparative endoscopic evaluation of the damaging effects of nonsteroidal anti-inflammatory agents on the gastric and duodenal mucosaAm J Gastroenterol751721PubMedGoogle Scholar
  19. 19.
    Naito, Y, Yoshikawa, T, Iinuma, S, Yagi, N, Matsuyama, K, Boku, Y,  et al. 1998Rebamipide protects against indomethacin-induced mucosal lesion in healthy volunteers in a double-blind, placebo-controlled studyDig Dis Sci43839Google Scholar
  20. 20.
    Hawkey, CJ, Karrasch, JA, Szczepanski, L, Walker, DG, Barkun, A, Swannell, AJ,  et al. 1998Omeprazole compared with misoprostol for ulcers associated with nonsteroidal antiinflammatory drugs. Omeprazole versus Misoprostol for NSAID-induced Ulcer Management (OMNIUM) Study GroupN Engl J Med33872734PubMedCrossRefGoogle Scholar
  21. 21.
    Wu, CS, Wang, SH, Chen, PC, Wu, VCC 1998Dose famotidine have similar efficacy to misoprostol in the treatment of non-steroidal anti-inflammatory drug-induced gastropathy?Int J Clin Pract524724PubMedGoogle Scholar
  22. 22.
    Miyake, K, Ueki, N, Suzuki, K, Shinji, Y, Kusunoki, M, Hiratsuka, T,  et al. 2005Preventive therapy for non-steroidal anti-inflammatory drug-induced ulcers in Japanese patients with rheumatoid arthritis: the current situation and a prospective controlled-study of the preventive effects of lansoprazole or famotidineAliment Pharmacol Ther216772PubMedCrossRefGoogle Scholar
  23. 23.
    Kitagami, K, Oku, K, Umemoto, N, Mizokami, Y, Shiozama, K, Yamana, S,  et al. 1993Clinical study of rebamipide for NSAIDs induced gastritisJ Adult Dis23147788Google Scholar
  24. 24.
    Matsuhisa, T, Hayama, T, Nakamura, H, Yoshino, S, Yamada, N 1998Clinical usefulness of rebamipide against symptoms, gastric lesions and histological gastritis caused by long-term administration of NSAIDs in patients with rheumatoid arthritisGastroenterology (Tokyo)2711830Google Scholar
  25. 25.
    Kinoshita, Y, Kawanami, C, Kishi, K, Nakata, H, Seino, Y, Chiba, T 1997Helicobacter pylori independent chronological change in gastric acid secretion in the JapaneseGut414528PubMedCrossRefGoogle Scholar
  26. 26.
    El-Omar, EM, Penman, ID, Ardill, JES, Chittajallu, RS, Howie, C, Mccoll, KEL 1995Helicobacter pylori infection and abnormalities of acid secretion in patients with duodenal ulcer diseaseGastroenterology10968191PubMedCrossRefGoogle Scholar
  27. 27.
    Feldman, M, Richardson, CT, Lam, SK, Samloff, IM 1988Comparison of gastric acid secretion rates and serum pepsinogen I and II concentrations in occidental and oriental duodenal ulcer patientsGastroenterology956305PubMedGoogle Scholar
  28. 28.
    Kawaguchi, H, Haruma, K, Komoto, K, Yoshihara, M, Sumii, K, Kajiyama, G 1996Helicobacter pylori infection is the major risk factor for atrophic gastritisAm J Gastroenterol9195962PubMedGoogle Scholar
  29. 29.
    Haruma, K, Kamada, T, Kawaguchi, H, Okamoto, S, Yoshihara, M, Sumii, K,  et al. 2000Effect of age and Helicobacter pylori infection on gastric acid secretionJ Gastroenterol Hepatol1527783PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Tokyo 2006

Authors and Affiliations

  • Jun-ichi Yamao
    • 1
  • Eiryo Kikuchi
    • 2
  • Masami Matsumoto
    • 3
  • Masaki Nakayama
    • 4
  • Tatsuichi Ann
    • 5
  • Hideyuki Kojima
    • 1
  • Akira Mitoro
    • 1
  • Motoyuki Yoshida
    • 1
  • Masaaki Yoshikawa
    • 1
  • Hiroshi Yajima
    • 6
  • Yoshizumi Miyauchi
    • 7
  • Hiroshi Ono
    • 8
  • Koichi Akiyama
    • 9
  • Goro Sakurai
    • 10
  • Yoshikazu Kinoshita
    • 11
  • Ken Haruma
    • 12
  • Yoshinori Takakura
    • 2
  • Hiroshi Fukui
    • 1
  1. 1.Third Department of Internal MedicineNara Medical UniversityKashiharaJapan
  2. 2.Department of Gastroenterological MedicineNara Prefectural Nara HospitalNaraJapan
  3. 3.Department of Internal MedicineNara Prefectural Gojo HospitalGojoJapan
  4. 4.Department of Internal MedicineNishi-Nara Chuo HospitalNaraJapan
  5. 5.Department of Internal MedicineKokuho Central HospitalNaraJapan
  6. 6.Department of Orthopedic SurgeryNara Medical UniversityKashiharaJapan
  7. 7.Department of Orthopedic SurgeryNara Prefectural Nara HospitalNaraJapan
  8. 8.Department of Orthopedic SurgeryKokuho Central HospitalNaraJapan
  9. 9.Department of Orthopedic SurgeryNara Prefectural Gojo HospitalGojoJapan
  10. 10.Department of Orthopedic SurgeryNishi-Nara Chuo HospitalNaraJapan
  11. 11.Department of Gastroenterology and HepatologyShimane University School of MedicineIzumoJapan
  12. 12.Division of Gastroenterology, Department of Internal MedicineKawasaki Medical SchoolKurashikiJapan

Personalised recommendations