# Rebamipide for Managing Dyspeptic Symptoms During Proton-Pump Inhibitor Washout Before Helicobacter pylori Testing: A Randomized, Double-Blind, Placebo-Controlled Trial

## TL;DR

A trial tested rebamipide to manage stomach symptoms during a drug-free period before H. pylori testing, but found no significant benefit.

## Contribution

A randomized controlled trial evaluated rebamipide's efficacy in managing dyspepsia during proton-pump inhibitor washout before H. pylori testing.

## Key findings

- The responder rate was higher in the rebamipide group but not statistically significant.
- Symptom improvement was similar in both the rebamipide and placebo groups.
- No serious adverse events were reported in either group.

## Abstract

Persistent dyspeptic symptoms are common during the proton pump inhibitor (PPI) washout period before Helicobacter pylori (H. pylori) testing. However, the role of rebamipide in symptom management during this interval remains unclear.

This double-blind, randomized controlled trial enrolled 65 patients with H. pylori–associated dyspepsia or gastritis, randomized (1:1) to receive rebamipide (100 mg 3 times daily) or placebo for 4 weeks, following a 14-day eradication regimen. The primary outcome was the proportion of responders achieving a ≥25% reduction in pain symptom scores on the Severity of Dyspepsia Assessment scale at week 6. Secondary outcomes included changes in pain symptoms, non-pain symptoms, and dyspepsia-related health scores, as well as eradication rates and safety.

All patients completed the trial. Although the proportion of responders was higher in the rebamipide group (18 patients, 56.3% vs. 13 patients, 39.4%), this difference was not statistically significant (P = .17). Scores for pain, non-pain, and dyspepsia-related health improved similarly in both groups. Eradication rates were comparable (87.5% vs. 90.0%), and no serious adverse events were reported.

The responder rate was higher in the rebamipide group, but the difference did not reach statistical significance. The potential benefit of rebamipide as a rescue therapy during the PPI washout period before H. pylori testing warrants further investigation in larger trials.