title: Determination of the adequate dosage of rebamipide, a gastric mucoprotective drug, to prevent low-dose aspirin-induced gastrointestinal mucosal injury.
abstract: Small intestinal mucosal injury caused by low-dose aspirin is a common cause of obscure gastrointestinal bleeding. We aimed to investigate the protective effects and optimal dose of rebamipide for low-dose aspirin-induced gastrointestinal mucosal injury. In this prospective randomized trial, 45 healthy volunteers (aged 20-65 years) were included and divided into three groups. The groups received enteric-coated aspirin 100 mg (low-dose aspirin) plus omeprazole 10 mg (Group A: proton pump inhibitor group), low-dose aspirin plus rebamipide 300 mg (Group B: standard-dose group), or low-dose aspirin plus rebamipide 900 mg (Group C: high-dose group). Esophagogastroduodenoscopy and video capsule endoscopy were performed, and the fecal occult blood reaction and fecal calprotectin levels were measured before and two weeks after drug administration. Although the fecal calprotectin levels increased significantly in Group A, they did not increase in Groups B and C. The esophagogastroduodenoscopic and video capsule endoscopic findings and the fecal occult blood test findings did not differ significantly among the three groups. In conclusion, standard-dose rebamipide is sufficient for preventing mucosal injury of the small intestine induced by low-dose aspirin, indicating that high-dose rebamipide is not necessary.
authors.affiliation: Second Department of Internal Medicine, Osaka Medical College, Daigaku-Machi, Takatsuki-shi, Osaka 569-8686, Japan; Department of Gastroenterology and Hepatology, Shiroyama Hospital, Habikino, Osaka, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Ota
authors.affiliation: Second Department of Internal Medicine, Osaka Medical College, Daigaku-Machi, Takatsuki-shi, Osaka 569-8686, Japan.
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Takeuchi
authors.affiliation: Second Department of Internal Medicine, Osaka Medical College, Daigaku-Machi, Takatsuki-shi, Osaka 569-8686, Japan.
authors.forename: Sadaharu
authors.initials: S
authors.lastname: Nouda
authors.affiliation: Second Department of Internal Medicine, Osaka Medical College, Daigaku-Machi, Takatsuki-shi, Osaka 569-8686, Japan.
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Ozaki
authors.affiliation: Second Department of Internal Medicine, Osaka Medical College, Daigaku-Machi, Takatsuki-shi, Osaka 569-8686, Japan.
authors.forename: Shinpei
authors.initials: S
authors.lastname: Kawaguchi
authors.affiliation: Second Department of Internal Medicine, Osaka Medical College, Daigaku-Machi, Takatsuki-shi, Osaka 569-8686, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Takahashi
authors.affiliation: Second Department of Internal Medicine, Osaka Medical College, Daigaku-Machi, Takatsuki-shi, Osaka 569-8686, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Harada
authors.affiliation: Second Department of Internal Medicine, Osaka Medical College, Daigaku-Machi, Takatsuki-shi, Osaka 569-8686, Japan.
authors.forename: Shoko
authors.initials: S
authors.lastname: Edogawa
authors.affiliation: Second Department of Internal Medicine, Osaka Medical College, Daigaku-Machi, Takatsuki-shi, Osaka 569-8686, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Kojima
authors.affiliation: Second Department of Internal Medicine, Osaka Medical College, Daigaku-Machi, Takatsuki-shi, Osaka 569-8686, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Kuramoto
authors.affiliation: Second Department of Internal Medicine, Osaka Medical College, Daigaku-Machi, Takatsuki-shi, Osaka 569-8686, Japan.
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Higuchi
keywords: capsule endoscopy; fecal calprotectin; gastrointestinal mucosal injury; low-dose aspirin; rebamipide