PMID- 35300126
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220319
IS  - 1178-7074 (Print)
IS  - 1178-7074 (Electronic)
IS  - 1178-7074 (Linking)
VI  - 15
DP  - 2022
TI  - Rebamipide as a Potential Alternative Gastroprotective Agent to Proton Pump 
      Inhibitor in Elderly Chronic Nonsteroidal Anti-Inflammatory Drug Users without 
      Risk Factors.
PG  - 2835-2845
LID - 10.2147/IJGM.S353098 [doi]
AB  - PURPOSE: The use of proton pump inhibitors (PPI) is recommended to prevent 
      nonsteroidal anti-inflammatory drug (NSAID)-induced gastrointestinal (GI) 
      complications. The incidence of several adverse effects during the long-term use 
      of PPI prompts the search for other alternatives. Limited studies have evaluated 
      the efficacy of rebamipide, a widely used mucoprotective drug, as a 
      gastroprotective agent (GPA) compared to PPI, focusing on the elderly chronic 
      NSAID users, nor with GI risk stratification. We aimed to determine the 
      population who would get benefit from the use of rebamipide as an alternative to 
      PPI to prevent traditional nonsteroidal anti-inflammatory drug 
      (tNSAID)-associated GI complications. PATIENTS AND METHODS: We identified 41,889 
      and 35,708 elderly chronic tNSAID users with PPI and rebamipide co-therapy, 
      respectively, from the national claims database. Outcome was defined as 
      hospitalization or emergency department visits due to serious GI complications. 
      Propensity score-matched cohorts were constructed and compared within risk 
      strata. RESULTS: In high and moderate risk groups with two risk factors, 
      rebamipide showed a higher risk of serious GI complication compared to PPI (aHR 
      2.63, 95% CI 1.24-5.59 and aHR 2.42, 95% CI 1.21-4.83, respectively). However, in 
      elderly patients without risk factors, there was no significant difference in the 
      risk of serious GI complications between PPI and rebamipide (aHR 0.69, 95% CI 
      0.27-1.76). CONCLUSION: This study suggested that rebamipide can be considered as 
      an alternative to PPI in elderly chronic tNSAID users without risk factors. 
      However, elderly patients with other risk factors should use PPI rather than 
      rebamipide. Therefore, the presence of GI risk factors needs to be evaluated in 
      elderly chronic tNSAID users to prescribe the most suitable GPA in clinical 
      practice.
CI  - (c) 2022 Lee et al.
FAU - Lee, Mee Yeon
AU  - Lee MY
AD  - College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul 
      National University, Seoul, Republic of Korea.
FAU - Lee, Suhyun
AU  - Lee S
AD  - College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul 
      National University, Seoul, Republic of Korea.
FAU - Heo, Kyu-Nam
AU  - Heo KN
AD  - College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul 
      National University, Seoul, Republic of Korea.
FAU - Kim, Woo-Youn
AU  - Kim WY
AD  - College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul 
      National University, Seoul, Republic of Korea.
FAU - Jung, Sun Hoi
AU  - Jung SH
AD  - Department of Pharmacy, Seoul National University Boramae Medical Center, Seoul, 
      Republic of Korea.
FAU - Ah, Young-Mi
AU  - Ah YM
AUID- ORCID: 0000-0003-1607-9828
AD  - College of Pharmacy, Yeungnam University, Gyeongsan-si, Republic of Korea.
FAU - Lee, Ju-Yeun
AU  - Lee JY
AUID- ORCID: 0000-0002-2261-7330
AD  - College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul 
      National University, Seoul, Republic of Korea.
LA  - eng
PT  - Journal Article
DEP - 20220310
PL  - New Zealand
TA  - Int J Gen Med
JT  - International journal of general medicine
JID - 101515487
PMC - PMC8922238
OTO - NOTNLM
OT  - aged
OT  - gastroprotective agent
OT  - nonsteroidal anti-inflammatory drug
OT  - rebamipide
OT  - risk group
COIS- The authors report no conflicts of interest in this work.
EDAT- 2022/03/19 06:00
MHDA- 2022/03/19 06:01
PMCR- 2022/03/10
CRDT- 2022/03/18 05:16
PHST- 2021/12/16 00:00 [received]
PHST- 2022/02/23 00:00 [accepted]
PHST- 2022/03/18 05:16 [entrez]
PHST- 2022/03/19 06:00 [pubmed]
PHST- 2022/03/19 06:01 [medline]
PHST- 2022/03/10 00:00 [pmc-release]
AID - 353098 [pii]
AID - 10.2147/IJGM.S353098 [doi]
PST - epublish
SO  - Int J Gen Med. 2022 Mar 10;15:2835-2845. doi: 10.2147/IJGM.S353098. eCollection 
      2022.