Digestive Diseases and Sciences

, Volume 63, Issue 5, pp 1250–1260 | Cite as

Efficacy of Rebamipide in Organic and Functional Dyspepsia: A Systematic Review and Meta-Analysis

  • Mohamed Hasif Jaafar
  • Sher Zaman Safi
  • Maw-Pin Tan
  • Sanjay Rampal
  • Sanjiv Mahadeva
Original Article

Abstract

Objective

The role of gastritis in dyspepsia remains controversial. We aimed to examine the efficacy of rebamipide, a gastric mucosal protective agent, in both organic and functional dyspepsia.

Design

A systematic review and meta-analysis was performed. The following databases were searched using the keywords (“rebamipide” OR “gastroprotective agent*” OR “mucosta”) AND (“dyspepsia” OR “indigestion” OR “gastrointestinal symptoms”): PubMed, Wed of Science, Embase, CINAHL, Cochrane Clinical Trials Register. The primary outcome was dyspepsia or upper GI symptom score improvement. Pooled analysis of the main outcome data were presented as risk ratio (RR) for dichotomous data and standardized mean difference (SMD) for continuous data.

Results

From an initial 248 records, 17 randomised controlled trial (RCT) publications involving 2170 subjects (1224 rebamipide, 946 placebo/control) were included in the final analysis. Twelve RCTs were conducted in subjects with organic dyspepsia (peptic ulcer disease, reflux esophagitis or NSAID-induced gastropathy) and five RCTs were conducted in patients with functional dyspepsia (FD). Overall, dyspepsia symptom improvement was significantly better with rebamipide compared to placebo/control drug (RR 0.77, 95% CI = 0.64–0.93; SMD −0.46, 95% CI = −0.83 to −0.09). Significant symptom improvement was observed both in pooled RR and SMD in subjects with organic dyspepsia (RR 0.72, 95% CI = 0.61–0.86; SMD −0.23, 95% CI = −0.4 to −0.07), while symptom improvement in FD was observed in pooled SMD but not RR (SMD −0.62, 95% CI = −1.16 to −0.08; RR 1.01, 95% CI = 0.71–1.45).

Conclusion

Rebamipide is effective in organic dyspepsia and may improve symptoms in functional dyspepsia.

Keywords

Rebamipide Gastritis Dyspepsia NSAID gastropathy Meta-analysis 

Notes

Acknowledgments

MPT was a recipient of a University of Malaya Grand Challenge fund which also funded the salary of MHJ (GC002-14HTM).

Author's contribution

SM planned the study, contributed to data collection, and drafted the manuscript. MHJ and SZS performed data collection and preliminary data analysis. MPT planned the study and performed data collection. SR performed final data analysis and contributed to the drafting of the manuscript. All authors agreed on the final draft of the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declared that they have no conflicts of interest.

Supplementary material

10620_2017_4871_MOESM1_ESM.jpg (111 kb)
Fig. 6 Funnel plot demonstrating pooled analysis for RCT studies with continuous outcomes for dyspepsia based on symptom duration ≤ 4 weeks and > 4 weeks (JPEG 111 kb)
10620_2017_4871_MOESM2_ESM.jpg (136 kb)
Fig. 7 Funnel plot demonstrating pooled analysis for RCT studies with categorical outcomes for dyspepsia based on various UGI symptom scales (JPEG 135 kb)
10620_2017_4871_MOESM3_ESM.jpg (110 kb)
Fig. 8 Funnel plot demonstrating pooled analysis for RCT studies with categorical outcomes for dyspepsia based on placebo compared with active drug control (JPEG 109 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Department of Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
  2. 2.Department of Social and Preventive Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
  3. 3.Interdisciplinary Research Center in Biomedical Materials (IRCBM), COMSATS Institute of Information TechnologyLahorePakistan

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