Journal of Gastroenterology

, Volume 45, Issue 3, pp 285–290 | Cite as

Clinical trial: rebamipide promotes gastric ulcer healing by proton pump inhibitor after endoscopic submucosal dissection—a randomized controlled study

  • Tomohiro Kato
  • Hiroshi Araki
  • Fumito Onogi
  • Takashi Ibuka
  • Akihiko Sugiyama
  • Eiichi Tomita
  • Masahito Nagaki
  • Hisataka Moriwaki
Original Article—Alimentary Tract

Abstract

Background

Endoscopic submucosal dissection (ESD) is useful for treating gastric tumors. Several trials have shown the efficacy of 4 or 8 weeks of proton pump inhibitor (PPI) administration for post-ESD ulcers. However, if the size of the post-ESD ulcer is larger than predicted, PPI administration alone might not be sufficient for the ulcer to heal within 4 weeks. We examined the efficacy of a combination therapy of PPI and rebamipide, a mucosal-protective antiulcer drug, on the acceleration of post-ESD ulcer healing.

Methods

Patients were randomly assigned to either the PPI and rebamipide therapy or the PPI alone. Sixty-two consecutive patients with gastric tumors gave informed consent for enrolling in the study. In all cases, the estimated size of the post-ESD ulcer was larger than 20 mm. Oral administration of the drug was started on the 2nd day post-ESD and continued to the 28th day.

Results

All patients received the assigned pharmaceuticals and adhered well to the treatment regimen for 28 days. The endpoint ulcers reached S1 (scar stage) in 11/31 (36%) patients in the PPI-only group and in 21/31 (68%) in the combination group (P = 0.010).

Conclusions

The combination of PPI plus rebamipide was more effective than the PPI alone for treating ulcers larger than 20 mm within 4 weeks after ESD.

Keywords

Endoscopic mucosal resection (EMR) Endoscopic submucosal dissection (ESD) Histamine H2 receptor antagonist (H2RA) Proton pump inhibitor (PPI) Rebamipide Gastric tumor Gastric cancer Ulcer healing 

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Copyright information

© Springer 2009

Authors and Affiliations

  • Tomohiro Kato
    • 1
    • 2
  • Hiroshi Araki
    • 1
  • Fumito Onogi
    • 1
  • Takashi Ibuka
    • 1
  • Akihiko Sugiyama
    • 2
  • Eiichi Tomita
    • 2
  • Masahito Nagaki
    • 1
  • Hisataka Moriwaki
    • 1
  1. 1.Department of GastroenterologyGifu University HospitalGifuJapan
  2. 2.Department of GastroenterologyGifu Municipal HospitalGifuJapan

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