Rebamipide as an Adjunctive Therapy for Gastrointestinal Diseases: An Umbrella Review

TL;DR

This umbrella review finds that rebamipide improves outcomes for various gastrointestinal disorders, including better H. pylori eradication and ulcer healing.

Contribution

This study provides a comprehensive synthesis of rebamipide's efficacy across multiple gastrointestinal conditions using high-quality meta-analyses.

Findings

Rebamipide significantly improves H. pylori eradication rates.

It reduces NSAID-induced mucosal injury and enhances ulcer healing.

Rebamipide alleviates dyspeptic symptoms with moderate to high evidence quality.

Abstract

Objective: This umbrella review aimed to synthesize evidence from meta-analyses on the efficacy of rebamipide in major gastrointestinal disorders and dyspeptic symptoms. Methods: This umbrella review followed Joanna Briggs Institute standards and was registered in PROSPERO (CRD420251185686). A comprehensive search of MEDLINE, EMBASE, Cochrane, and Scopus (1 January 1985, to 10 September 2025) was conducted to identify systematic reviews and meta-analyses assessing rebamipide therapy. Methodological quality was appraised using AMSTAR-2, ROBIS, and GRADE tools. Pooled data were analyzed using fixed- or random-effects models according to heterogeneity, as assessed using the I2 statistic. Results: Eleven meta-analyses (88 primary studies) were included. Rebamipide significantly improved H. pylori eradication (OR = 1.76; 95% CI: 1.44–2.16), reduced NSAID-induced mucosal injury (OR = 2.72; 95% CI: 1.89–5.14), enhanced ulcer healing after endoscopic submucosal dissection (OR = 2.28; 95% CI: 1.42–3.65), and alleviated dyspeptic symptoms (OR = 2.95; 95% CI: 1.04–8.37). Overall evidence quality was moderate to high, with low to moderate risk of bias. Conclusions: Rebamipide demonstrates consistent therapeutic benefits across diverse gastrointestinal disorders, improving H. pylori eradication rates, mucosal protection, ulcer healing, and symptom relief. These findings support rebamipide as an effective and well-tolerated adjunctive agent for the prevention and management of upper gastrointestinal diseases.

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