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

Abstract

<b>Objective</b>: This umbrella review aimed to synthesize evidence from meta-analyses on the efficacy of rebamipide in major gastrointestinal disorders and dyspeptic symptoms. <b>Methods</b>: 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. <b>Results</b>: Eleven meta-analyses (88 primary studies) were included. Rebamipide significantly improved <i>H. pylori</i> 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. <b>Conclusions</b>: Rebamipide demonstrates consistent therapeutic benefits across diverse gastrointestinal disorders, improving <i>H. pylori</i> 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.