지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2014.1
- 수록면
- 371 - 379 (9page)
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초록· 키워드
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Background/Aims: The use of proton pump inhibitors ormisoprostol is known to prevent the gastrointestinal complicationsof nonsteroidal anti-inflammatory drugs (NSAIDs). Rebamipide is known to increase the mucosal generation ofprostaglandins and to eliminate free oxygen radicals, thusenhancing the protective function of the gastric mucosa. However, it is unknown whether rebamipide plays a role inpreventing NSAID-induced gastropathy. The aim of this studywas to determine the effectiveness of rebamipide comparedto misoprostol in preventing NSAID-induced gastrointestinalcomplications in patients requiring continuous NSAID treatment.
Methods: We studied 479 patients who required continuousNSAID treatment. The patients were randomly assignedto groups that received 100 mg of rebamipide threetimes per day or 200 μg of misoprostol three times per dayfor 12 weeks. The primary endpoint of the analysis was theoccurrence rate of gastric ulcers, as determined by endoscopyafter 12 weeks of therapy.
Results: Of the 479 patients inthe study, 242 received rebamipide, and 237 received misoprostol. Ultimately, 44 patients (18.6%) withdrew from themisoprostol group and 25 patients (10.3%) withdrew fromthe rebamipide group. There was a significant difference inwithdrawal rate between the two groups (p=0.0103). The perprotocol analysis set was not valid because of the dropoutrate of the misoprostol group; thus, the intention to treat (ITT)analysis set is the main set for the efficacy analysis in thisstudy. After 12 weeks, the occurrence rate of gastric ulcerswas similar in the rebamipide and misoprostol groups (20.3% vs 21.9%, p=0.6497) according to ITT analysis. In addition,the therapeutic failure rate was similar in the rebamipideand misoprostol groups (13.6% vs 13.1%, p=0.8580). Thetotal severity score of the gastrointestinal symptoms wassignificantly lower in the rebamipide group than in the misoprostolgroup (p=0.0002). The amount of antacid used wassignificantly lower in the rebamipide group than in the misoprostolgroup (p=0.0258).
Conclusions: Rebamipide canprevent gastric ulcers when used with NSAIDs and can decreasethe gastrointestinal symptoms associated with NSAIDadministration. When the possibility of poor compliance andthe potential adverse effects of misoprostol are considered,rebamipide appears to be a clinically effective and safe alternative.
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참고문헌 (21)
참고문헌 신청
Arakawa T / 1998 / Rebamipide: overview of its mechanisms of action and efficacy in mucosal protection and ulcer healing / Dig Dis Sci 43 (9 Suppl) : 5S ~ 13S
Back M / 2012 / Cyclooxygenase-2 inhibitors and cardiovascular risk in a nation-wide cohort study after the withdrawal of rofecoxib / Eur Heart J 33 : 1928 ~ 1933
Ballinger AB / 1992 / Misoprostol in the prevention of gastroduodenal damage in rheumatology / Ann Rheum Dis 51 : 1089 ~ 1093
Garcia Rodriguez LA / 2001 / The risk of upper gastrointestinal complications associated with nonsteroidal anti-inflammatory drugs, glucocorticoids, acetaminophen, and combin
Goldkind L / 2006 / Patients, their doctors, nonsteroidal anti-inflammatory drugs and the perception of risk / Arthritis Res Ther 8 : 105 ~
Back M / 2012 / Cyclooxygenase-2 inhibitors and cardiovascular risk in a nation-wide cohort study after the withdrawal of rofecoxib / Eur Heart J 33 : 1928 ~ 1933
Ballinger AB / 1992 / Misoprostol in the prevention of gastroduodenal damage in rheumatology / Ann Rheum Dis 51 : 1089 ~ 1093
Garcia Rodriguez LA / 2001 / The risk of upper gastrointestinal complications associated with nonsteroidal anti-inflammatory drugs, glucocorticoids, acetaminophen, and combin
Goldkind L / 2006 / Patients, their doctors, nonsteroidal anti-inflammatory drugs and the perception of risk / Arthritis Res Ther 8 : 105 ~
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