title: A study on the efficacy of rebamipide for patients with proton pump inhibitor-refractory non-erosive reflux disease.
abstract: OBJECTIVE
  Reflux symptoms in patients with non-erosive reflux disease (NERD) cannot be easily controlled by treatment with proton pump inhibitors (PPI). The anti-inflammatory function of rebamipide may be effective for protecting the esophageal mucosa. This prospective randomized multicenter placebo-controlled study was performed to clarify the efficacy of rebamipide for NERD patients whose reflux symptoms were refractory to PPI treatment.
  
  
  METHODS
  One hundred forty-nine patients were enrolled on the basis of a QUEST score of over 6 and absence of endoscopically proven esophageal mucosal breaks. All the patients were initially administered 15 mg of lansoprazole for 4 weeks, and the symptoms were then assessed using QUEST and GSRS. PPI-refractory patients were randomly assigned to administration of rebamipide or placebo t.i.d. for 4 weeks.
  
  
  RESULTS
  Three of the 149 patients were lost to follow-up, and 60 among the remaining 146 patients were found to be PPI-refractory. Among these PPI-refractory patients, 31 were randomly assigned to a rebamipide group and 29 to a placebo group. At the end of drug administration, the QUEST and GSRS scores did not differ between the rebamipide and placebo groups, although a significantly higher proportion of patients in the rebamipide group showed amelioration of abdominal pain and diarrhea.
  
  
  CONCLUSIONS
  Administration of rebamipide cannot effectively control reflux symptoms in NERD patients whose symptoms are refractory to PPI therapy.
authors.affiliation: Department of Clinical Nursing, Shimane University Faculty of Medicine, Izumo City, Shimane, Japan. kadachi@med.shimane-u.ac.jp
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Adachi
authors.forename: Kenji
authors.initials: K
authors.lastname: Furuta
authors.forename: Hiroto
authors.initials: H
authors.lastname: Miwa
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Oshima
authors.forename: Masaharu
authors.initials: M
authors.lastname: Miki
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Komazawa
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Iwakiri
authors.forename: Takahisa
authors.initials: T
authors.lastname: Furuta
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Koike
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Shimatani
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Kinoshita
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000409:Alanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004351:Drug Resistance; D050782:Esophageal pH Monitoring; D004945:Esophagoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D064747:Lansoprazole; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D015363:Quinolones / Q000627:therapeutic use*; D012008:Recurrence; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D054328:Proton Pump Inhibitors; D015363:Quinolones; D064747:Lansoprazole; C052785:rebamipide; D000409:Alanine