Efficacy and safety of rebamipide/nizatidine in patients with erosive gastritis: A randomized, multicenter, phase 4 study

World J Gastroenterol. 2024 Dec 28;30(48):5152-5161. doi: 10.3748/wjg.v30.i48.5152.

Abstract

Background: For the treatment of gastritis, rebamipide, a mucoprotective agent, and nizatidine, a gastric acid suppressant, are commonly employed individually.

Aim: To compare the efficacy of Mucotra® SR (rebamipide 150 mg) and Axid® (nizatidine 150 mg) combination therapy with the sole administration of Axid® in managing erosive gastritis.

Methods: A total of 260 patients diagnosed with endoscopically confirmed erosive gastritis were enrolled in this open-label, multicenter, randomized, phase 4 clinical trial, allocating them into two groups: Rebamipide/nizatidine combination twice daily vs nizatidine twice daily for 2 weeks. The full-analysis set analysis encompassed 239 patients (rebamipide/nizatidine, n = 121; nizatidine, n = 118), while the per-protocol analysis included 218 patients (n = 110 vs 108). Post-treatment assessments comprised primary (erosion improvement rate) and secondary (erosion and edema cure rates, erythema improvement rates, hemorrhage, and gastrointestinal symptoms) endpoints. Furthermore, drug-related adverse effects were evaluated.

Results: Primary efficacy assessment showed a statistically significant improvement rate in mucosal erosions in the combination group compared to the control group in the full-analysis set (rebamipide/nizatidine 62.0%, nizatidine 49.2%, P = 0.046), with a similar trend noted in the per-protocol analysis (62.7% vs 50.0%, P = 0.058). Both groups were effective in curing erosion and edema and improvement of bleeding, erythema, and gastrointestinal symptoms, whereas no inter-group differences were noted. When confined to the participants with gastritis symptoms, improvement of erosion was more optimal in the combination group (63.0% vs 49.5%, P = 0.046). No adverse events related to the drugs were observed.

Conclusion: Rebamipide/nizatidine combination is effective in treatment of erosive gastritis.

Keywords: Combination therapy; Erosive gastritis; Gastritis; Nizatidine; Rebamipide.

Publication types

  • Clinical Trial, Phase IV
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Alanine* / administration & dosage
  • Alanine* / adverse effects
  • Alanine* / analogs & derivatives
  • Alanine* / therapeutic use
  • Anti-Ulcer Agents / administration & dosage
  • Anti-Ulcer Agents / adverse effects
  • Anti-Ulcer Agents / therapeutic use
  • Drug Therapy, Combination / methods
  • Female
  • Gastric Mucosa / drug effects
  • Gastric Mucosa / pathology
  • Gastritis* / diagnosis
  • Gastritis* / drug therapy
  • Gastroscopy
  • Humans
  • Male
  • Middle Aged
  • Nizatidine* / administration & dosage
  • Nizatidine* / adverse effects
  • Nizatidine* / therapeutic use
  • Quinolones* / administration & dosage
  • Quinolones* / adverse effects
  • Quinolones* / therapeutic use
  • Treatment Outcome

Substances

  • Alanine
  • Anti-Ulcer Agents
  • Nizatidine
  • Quinolones
  • rebamipide