Rebamipide prevents occurrence of gastric lesions following transcatheter arterial embolization in the hepatic artery.
BACKGROUND
Transcatheter arterial embolization (TAE) of the hepatic artery is a common treatment method for hepatocellular carcinoma (HCC), but it often induces gastric mucosal injury. We examined whether or not rebamipide administration, beginning 1 week before and ending 2 weeks afterTAE, can prevent worsening of gastric mucosal disorders.


METHODS
The subjects were 73 chronic hepatitis C or type C liver cirrhosis patients who concomitantly had HCC and received TAE in our hospital. The patients were randomly allocated to the rebamipide group (oral, 300 mg/day for 3 weeks starting 1 week before TAE) or the non-rebamipide group. Gastric endoscopy was performed 1 week before and 2 weeks afterTAE and the presence of erythema, erosion and/or submucosal haemorrhagic spots was monitored. Based on the findings, gastric mucosal disorder before and after TAE was quantitatively evaluated using the modified Lanza score (MLS).


RESULTS
Overall, MLS after TAE increased significantly (P< 0.05). However, in the rebamipide group, MLS did not change. The MLS after TAE increased significantly in patients who had either liver cirrhosis, oesophageal varices or gastropathy (P< 0.01 or < 0.05). In the non-rebamipide group, a significant increase in MLS after TAE was observed in patients who had one of the above-mentioned three diseases (P< 0.01 or < 0.05).


CONCLUSIONS
Gastric lesions which were present before TAE were significantly worsened after TAE. Rebamipide administration prevents TAE-induced aggravation of gastric lesions.
Nomura
H
H
Department of Internal Medicine, Shin-Kokura Hospital, Kanada, Kitakyushu, Japan.
Miyake
K
K
Hirakata
R
R
Migita
S
S
Okamoto
O
O
Shiraishi
G
G
D000328:Adult; D000368:Aged; D000409:Alanine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000009:adverse effects; D004932:Esophageal and Gastric Varices / Q000188:drug therapy / Q000517:prevention & control*; D005260:Female; D005753:Gastric Mucosa / Q000187:drug effects; D006499:Hepatic Artery; D019698:Hepatitis C, Chronic / Q000150:complications; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015363:Quinolones / Q000008:administration & dosage*; D013276:Stomach Ulcer / Q000188:drug therapy / Q000517:prevention & control*
D015363:Quinolones; C052785:rebamipide; D000409:Alanine