Rebamipide in optimization of Helicobacter pylori eradication therapy: A review of evidence base
Abstract. In the context of increasing H. pylori resistance to antibiotics, the inclusion of rebamipide in eradication therapy (ET) regimens is a pathogenetically justified strategy that implements multitarget-mediated anti-Helicobacter mechanisms, including inhibition of adhesion and urease activity, suppression of the NF-κB signaling pathway, and enhancement of mucosal cytoprotection. According to the results of systematic reviews and meta-analyses, the adjuvant use of rebamipide significantly increases the efficacy of ET (odds ratio 1.75–2.16), and according to prospective Russian randomized clinical trials (RCTs) and the observational registry Hp-EuReg, its use allows achieving a clinically acceptable eradication rate of 90–96% (vs. 79–85% in control groups). Of fundamental importance is the ability of the drug to overcome clarithromycin resistance, as was demonstrated in a recent RCT. Rebamipide has a favorable safety profile, reducing the incidence of adverse events during ET (21.08 vs. 24.57% in the control) and accelerating reparative processes, justifying its use as a highly effective adjuvant agent for optimizing first-line ET, as well as its use in the post-eradication period.D.N. Andreev, I.V. Maev, D.S. Bordin, Yu.A. Kucheryavyy
Keywords
Helicobacter pylori
eradication therapy
rebamipide
References
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About the Authors
Dmitry N. Andreev, MD, PhD (Medicine), associate professor, head of the Department of functional research methods in gastroenterology, associate professor of the Department of propaedeutics of internal diseases and gastroenterology, Russian University of Medicine, Moscow, Russian Federation.E-mail: dna-mit8@mail.ru
ORCID: https://orcid.org/0000-0002-4007-7112
Igor V. Maev, MD, Dr. Sci. (Medicine), professor, academician of RAS, Honored Physician of the Russian Federation, Honored Scientist of the Russian Federation, first vice-rector, head of the Department of propaedeutics of internal diseases and gastroenterology, Russian University of Medicine, Moscow, Russian Federation.
ORCID: https://orcid.org/0000-0001-6114-564X
Dmitry S. Bordin, MD, Dr. Sci. (Medicine), head of the Department of pancreatic, biliary, and upper digestive tract pathology, A.S. Loginov Moscow Clinical Scientific and Practical Center; professor of the Department of propaedeutics of internal diseases and gastroenterology, Russian University of Medicine; professor of the Department of general medical practice and family medicine of the Faculty of postgraduate education, Tver State Medical University, Tver, Russian Federation.
ORCID: https://orcid.org/0000-0003-2815-3992
Yuri A. Kucheryavy, MD, PhD (Medicine), associate professor, scientific director of the Department of gastroenterology, Ilyinsky Hospital, Moscow region, Krasnogorsk urban district, Glukhovo village, Russian Federation.
ORCID: https://orcid.org/0000-0001-7760-2091
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