Real-World Effectiveness of Rebamipide on Gastritis Symptoms: A Patient-Focused Approach

Rebamipide is a gastric mucosal protectant used to relieve gastritis symptoms. Real-world evidence on the comparative effectiveness of rebamipide monotherapy versus combination therapy with proton-pump inhibitors (PPIs) in routine clinical settings is limited. This study evaluated the effect of rebamipide in reducing subjective gastrointestinal (GI) symptoms among patients with gastritis symptoms using a patient-focused approach. This multicenter, observational study enrolled patients aged 19 years and older who were prescribed rebamipide for gastritis symptoms across 81 local clinics and hospitals. Patients received rebamipide twice daily for 2 weeks, with an optional 4-week extension. GI symptom severity and frequency were collected via patient-reported outcomes at baseline and posttreatment. Patients were categorized into a rebamipide monotherapy group and a combination therapy group, with inverse probability of treatment weighting (IPTW) applied to adjust for baseline confounding. Statistical analyses included ANCOVA for symptom score changes and chi-square tests for categorical symptom improvement. Of the 2209 patients included in the analysis, 1946 were in the monotherapy and 263 were in the combination therapy. Both treatment groups showed significant posttreatment reductions in GI symptom scores, and there was no significant difference between the two groups in severity, frequency, and total score before and after IPTW (p > 0.05). The symptom improvement rate (≥ 50% reduction) was 71.5% in the monotherapy group and 71.4% in the combination therapy group, with no significant difference between the two groups (p = 0.976). Rebamipide monotherapy provided similar levels of GI symptom relief compared to combination therapy with PPIs in a real-world clinical setting.