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Использование ребамипида в качестве цитопротективного и противовоспалительного средства при энтеропатиях, индуцированных нестероидными противовоспалительными препаратами
Маев И.В., Казюлин А.Н. Использование ребамипида в качестве цитопротективного и противовоспалительного средства при энтеропатиях, индуцированных нестероидными противовоспалительными препаратами. Consilium Medicum. 2016; 18 (8): 8–12. DOI: 10.26442/2075-1753_2016.8.8-12
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Maev I.V., Kazyulin A.N. Using rebamipide as a cytoprotective and anti-inflammatory agent in enteropathy induced by nonsteroidal anti-inflammatory drugs. Consilium Medicum. 2016; 18 (8): 8–12. DOI: 10.26442/2075-1753_2016.8.8-12
Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Аннотация
В мире отмечается увеличение частоты НПВП-энтеропатии, что связано с чрезвычайно широким применением нестероидных противовоспалительных препаратов (НПВП) практически во всех разделах медицины, многофакторностью развития НПВП-энтеропатии (энтеропатии, индуцированной НПВП). Крайне тревожными являются трудность в диагностике данной патологии и возможность ее развития уже с 1, 2, 4-й недели приема. Соответственно, важным элементом профилактики и лечения НПВП-энтеропатии становится использование средств, оказывающих цитопротективное действие на слизистую оболочку тонкой кишки. Среди данных средств большой терапевтический потенциал имеет цитопротектор ребамипид. Большое количество экспериментальных и клинических исследований свидетельствует, что прием ребамипида является обоснованным и для условно здоровых лиц при необходимости короткого курса НПВП, и для больных, которым необходим их длительный или пожизненный прием, особенно при наличии факторов риска развития НПВП-энтеропатии.
Ключевые слова: энтеропатии, индуцированные нестероидными противовоспалительными препаратами, ребамипид, капсульная эндоскопия.
Ключевые слова: энтеропатии, индуцированные нестероидными противовоспалительными препаратами, ребамипид, капсульная эндоскопия.
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The increase in the incidence of NSAID-induced enteropathy, which is associated with an extremely wide application of nonsteroidal anti-inflammatory drugs (NSAIDs) in almost all branches of medicine, multifactor developing NSAID-induced enteropathy (enteropathy induced by NSAIDs) is marked in the world today. Extremely alarming is the difficulty in diagnosing this disease and the possibility of its development since the 1, 2, 4 th week of reception. Accordingly, an important element in the prevention and treatment of NSAID-enteropathy is the use of funds that have a cytoprotective effect on the mucous membrane of the small intestine. Among these tools is a great therapeutic potential cytoprotector rebamipide. A large number of experimental and clinical studies suggests that taking rebamipide is reasonable and relatively healthy persons, if necessary, a short course of nonsteroidal anti-inflammatory drugs for patients who require long-term or lifelong them welcome, especially if you have risk factors for NSAID-induced enteropathy.
Key words: enteropathy induced by non-steroidal anti-inflammatory drugs, rebamipide, capsule endoscopy.
Key words: enteropathy induced by non-steroidal anti-inflammatory drugs, rebamipide, capsule endoscopy.
Полный текст
Список литературы
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9. Allison MC, Howatson AG, Torrance CJ et al. Gastrointestinal damage associated with the use of nonsteroidal antiinflammatory drugs. N Engl J Med 1992; 327: 751–6.
10. Евсеев М.А., Круглянский Ю.М. НПВП-индуцированная энтеропатия: особенности эпидемиологии, патогенеза и клинического течения. РМЖ. 2008; 7: 523–8. / Evseev M.A., Kruglianskii Iu.M. NPVP-indutsirovannaia enteropatiia: osobennosti epidemiologii, patogeneza i klinicheskogo techeniia. RMZh. 2008; 7: 523–8. [in Russian]
11. Zardawi IM, Prematilake S. NSAID-associated protein losing enteropathy with fatal outcome. Pathology 2012; 44 (5): 489–92.
12. Tacheci I, Bradna P, Douda T et al. NSAID-Induced Enteropathy in Rheumatoid Arthritis Patients with Chronic Occult Gastrointestinal Bleeding: A Prospective Capsule Endoscopy Study. Gastroenterol Res Pract 2013; 2013. Article ID 268382. http://dx.doi.org/10.1155/2013/268382
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14. Mс Adam BF, Catella-Lawson E, Mardini IA et al. Systemic biosynthesis of prostacyclin by cyclooxigenase (COX)-2: the human pharmacology of a selective inhibitors of COX-2. PNAS 1999; 96: 272–7.
15. Bjarnason I, Zanelli G, Smith T et al. Nonsteroidal antiinflammatory drug-induced intestinal inflammation in humans. Gastroenterology 1987; 93: 480–9.
16. Scholz FJ, Heiss FW, Roberts PL. Diaphragmlike strictures of the small bowel associated with use of nonsteroidal antiinflammatory drugs. Am J Roentgenol 1994; 162 (1): 49–50.
17. Higuchi K, Umegaki E, Watanabe T et al. Present status and strategy of NSAIDs-induced small bowel injury. J Gastroenterol 2009; 44 (9): 879–88.
18. Slesser AA, Wharton R, Smith GV, Buchanan GN. Systematic review of small bowel diaphragm disease requiring surgery. Colorectal Dis 2012; 14 (7): 804–13.
19. Bogas M, Afonso Mdo C, Araújo D. Non-steroidal anti-inflammatory drugs and lower intestinal tract toxicity Acta Reumatol Port 2006; 31 (3): 227–35.
20. Maiden L. Capsule endoscopic diagnosis of nonsteroidal antiinfl ammatory drug-induced enteropathy J Gastroenterol 2009; 44 (Suppl. XIX): 64–71.
21. Wallace JL. Mechanisms, prevention and clinical implications of nonsteroidal anti-inflammatory drug-enteropathy. World J Gastroenterol 2013; 19 (12): 1861–76.
22. Дудаева Н.Г. Клинико-морфологическая характеристика энтеропатии, индуцированной нестероидными противовоспалительными препаратами. Бюллетень медицинских Интернет‐конференций. 2013; 3 (3). / Dudaeva N.G. Kliniko-morfologicheskaia kharakteristika enteropatii, indutsirovannoi nesteroidnymi protivovospalitel'nymi preparatami. Biulleten' meditsinskikh Internet‐konferentsii. 2013; 3 (3). [in Russian]
23. Кляритская И.Л., Балабанцева А.П., Фурсова В.А. Энтеропатии, индуцированные приемом нестероидных противовоспалительных препаратов. Кримський терапевтичний журн. 2014; 1: 38–44. / Kliaritskaia I.L., Balabantseva A.P., Fursova V.A. Enteropatii, indutsirovannye priemom nesteroidnykh protivovospalitel'nykh preparatov. Krims'kii terapevtichnii zhurn. 2014; 1: 38–44. [in Russian]
24. Reuter BK, Davies NM, Wallace JL. Nonsteroidal anti-inflammatory drug enteropathy in rats: role of permeability, bacteria, and enterohepatic circulation. Gastroenterology 1997; 112: 109–17.
25. Davies NM, Saleh JY, Skjodt NM. Detection and prevention of NSAID-induced enteropathy J Pharm Pharm Sci 2000; 3 (1): 137–55.
26. Damms A, Bischoff SC. Validation and clinical significance of a new calprotectin rapid test for the diagnosis of gastrointestinal diseases. Int J Colorectal Dis 2008; 23: 985–92.
27. Laine L, Connors LG, Reicin A et al. Serious lower gastrointestinal clinical events with nonselective NSAID or coxib use. Gastroenterology 2003; 124 (2): 288–92.
28. Endo H, Hosono K, Inamori M et al. Characteristics of small bowel injury in symptomatic chronic low-dose aspirin users: the experience of two medical centers in capsule endoscopy. J Gastroenterol 2009; 44: 544–9.
29. Endo H, Hosono K, Inamori M. Incidence of Small Bowel Injury Induced by Low-Dose Aspirin: A Crossover Study Using Capsule Endoscopy in Healthy Volunteers. Digestion 2009; 79: 44–51.
30. Maehata Y, Esaki M, Kochi S et al. Small bowel injury induced by selective cyclooxygenase-2 inhibitors: a prospective, double-blind, randomized clinical trial comparing celecoxib and meloxicam. J Gastroenterol 2012; 47 (4): 387–93.
31. Watari L, Oka S, Tanaka A et al. Comparison of small-bowel mucosal injury between low-dose aspirin and non-aspirin non-steroidal anti-inflammatory drugs: a capsule endoscopy study. Digestion 2014; 89 (3): 225–31.
32. Genta RM. Review article: the role of rebamipide in the management of inflammatory disease of the gastrointestinal tract. Aliment Pharmacol Ther 2003; 18: 8S–13S.
33. Mizukami K, Murakami K, Abe T et al. Aspirin-induced small bowel injuries and the preventive effect of rebamipide. World J Gastroenterol 2011; 17 (46): 5117–22.
34. Imaeda H, Fujimoto T, Takahashi K et al. Terminal-restriction fragment length polymorphism (T-RFLP) analysis for changes in the gut microbiota profiles of indomethacin- and rebamipide-treated mice. Digestion 2012; 86: 250–7.
35. Tanigawa T, Watanabe T, Otani K et al Rebamipide inhibits indomethacin-induced small intestinal injury: possible involvement of intestinal microbiota modulation by upregulation of alpha-defensin 5. Eur J Pharmacol 2013; 704: 64–9.
36. Watanabe T, Takeuchi T, Handa O. A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial of High-Dose Rebamipide Treatment for Low-Dose Aspirin-Induced Moderate-to-Severe Small Intestinal Damage. PLoS ONE. Doi: 10.1371/journal.pone.0122330 April 15, 2015.
37. Niwa Y, Nakamura M, Ohmiya N et al. Efficacy of rebamipide for diclofenac-induced small-intestinal mucosal injuries in healthy subjects: a prospective, randomized, double-blinded, placebo-controlled, cross-over study. J Gastroenterol 2008; 43 (4): 270–6.
38. Nishida U, Kato M, Nishida M et al. Evaluation of small bowel blood flow in healthy subjects receiving low-dose aspirin. World J Gastroenterol 2011; 17: 226–30.
39. Kurokawa S, Katsuki S, Fujita T et al. A randomized, double-blinded, placebo-controlled, multicenter trial, healing effect of rebamipide in patients with low-dose aspirin and/or non-steroidal anti-inflammatory drug induced small bowel injury. J Gastroenterol 2014; 49 (2): 239–44.
40. Fujimori S, Takahashi Y, Gudis K et al. Rebamipide has the potential to reduce the intensity of NSAID-induced small intestinal injury: a double-blind, randomized, controlled trial evaluated by capsule endoscopy. J Gastroenterol 2011; 46 (1): 57–64.
41. Zhang S, Qing Q, Bai Y et al. Rebamipide Helps Defend Against Nonsteroidal Anti-Inflammatory Drugs Induced Gastroenteropathy: A Systematic Review and Meta-Analysis. Dig Dis Sci 2013; 58 (7): 1991–2000.
2. Маев И.В., Самсонов А.А., Андреев Д.Н. Гастропатии, индуцированные нестероидными противовоспалительными средствами: патогенетически обоснованные подходы к профилактике и терапии. Фарматека. 2016; 2: 49–54. / Maev I.V., Samsonov A.A., Andreev D.N. Gastropatii, indutsirovannye nesteroidnymi protivovospalitel'nymi sredstvami: patogeneticheski obosnovannye podkhody k profilaktike i terapii. Farmateka. 2016; 2: 49–54. [in Russian]
3. Абдулганиева Д.И., Салихов И.Г. Гастроэнтерологические проблемы при ревматических заболеваниях. Практ. медицина. 2011; 1: 89–95. / Abdulganieva D.I., Salikhov I.G. Gastroenterologicheskie problemy pri revmaticheskikh zabolevaniiakh. Prakticheskaia meditsina. 2011; 1: 89–95. [in Russian]
4. Парфенов А.И. Энтерология. М.: Триада-Х, 2002. / Parfenov A.I. Enterologiia. M.: Triada- Х, 2002. [in Russian]
5. Каратеев А.Е., Насонова В.А. Энтеропатия, индуцированная нестероидными, противовоспалительными препаратами. Терапевт. арх. 2004; 2: 79–82. / Karateev A.E., Nasonova V.A. Enteropatiia, indutsirovannaia nesteroidnymi, protivovospalitel'nymi preparatami. Terapevt. arkh. 2004; 2: 79–82. [in Russian]
6. Загребина Е.А. Клинико-функциональная характеристика энтеропатий, индуцированных нестероидными противовоспалительными препаратами. Автореф. дис. … канд. мед. наук. Ижевск, 2010. / Zagrebina E.A. Kliniko-funktsional'naia kharakteristika enteropatii, indutsirovannykh nesteroidnymi protivovospalitel'nymi preparatami. Avtoref. dis. … kand. med. nauk. Izhevsk, 2010. [in Russian]
7. Bjarnason I, Hayllar J, MacPherson AJ, Russell AS. Side effects of nonsteroidal anti-inflammatory drugs on the small and large intestine in humans. Gastroenterology 1993; 104: 1832–47.
8. Bjarnason I, Takeuchi K. Intestinal permeability in the pathogenesis of NSAID-induced enteropathy. J Gastroenterol 2009; 44 (Suppl. 19): 23–9.
9. Allison MC, Howatson AG, Torrance CJ et al. Gastrointestinal damage associated with the use of nonsteroidal antiinflammatory drugs. N Engl J Med 1992; 327: 751–6.
10. Евсеев М.А., Круглянский Ю.М. НПВП-индуцированная энтеропатия: особенности эпидемиологии, патогенеза и клинического течения. РМЖ. 2008; 7: 523–8. / Evseev M.A., Kruglianskii Iu.M. NPVP-indutsirovannaia enteropatiia: osobennosti epidemiologii, patogeneza i klinicheskogo techeniia. RMZh. 2008; 7: 523–8. [in Russian]
11. Zardawi IM, Prematilake S. NSAID-associated protein losing enteropathy with fatal outcome. Pathology 2012; 44 (5): 489–92.
12. Tacheci I, Bradna P, Douda T et al. NSAID-Induced Enteropathy in Rheumatoid Arthritis Patients with Chronic Occult Gastrointestinal Bleeding: A Prospective Capsule Endoscopy Study. Gastroenterol Res Pract 2013; 2013. Article ID 268382. http://dx.doi.org/10.1155/2013/268382
13. Morris AJ, Wasson LA, Mackenzie JF. Small bowel enteroscopy in undiagnosed gastrointestinal blood loss. Gut 1992; 33 (7): 887–9.
14. Mс Adam BF, Catella-Lawson E, Mardini IA et al. Systemic biosynthesis of prostacyclin by cyclooxigenase (COX)-2: the human pharmacology of a selective inhibitors of COX-2. PNAS 1999; 96: 272–7.
15. Bjarnason I, Zanelli G, Smith T et al. Nonsteroidal antiinflammatory drug-induced intestinal inflammation in humans. Gastroenterology 1987; 93: 480–9.
16. Scholz FJ, Heiss FW, Roberts PL. Diaphragmlike strictures of the small bowel associated with use of nonsteroidal antiinflammatory drugs. Am J Roentgenol 1994; 162 (1): 49–50.
17. Higuchi K, Umegaki E, Watanabe T et al. Present status and strategy of NSAIDs-induced small bowel injury. J Gastroenterol 2009; 44 (9): 879–88.
18. Slesser AA, Wharton R, Smith GV, Buchanan GN. Systematic review of small bowel diaphragm disease requiring surgery. Colorectal Dis 2012; 14 (7): 804–13.
19. Bogas M, Afonso Mdo C, Araújo D. Non-steroidal anti-inflammatory drugs and lower intestinal tract toxicity Acta Reumatol Port 2006; 31 (3): 227–35.
20. Maiden L. Capsule endoscopic diagnosis of nonsteroidal antiinfl ammatory drug-induced enteropathy J Gastroenterol 2009; 44 (Suppl. XIX): 64–71.
21. Wallace JL. Mechanisms, prevention and clinical implications of nonsteroidal anti-inflammatory drug-enteropathy. World J Gastroenterol 2013; 19 (12): 1861–76.
22. Дудаева Н.Г. Клинико-морфологическая характеристика энтеропатии, индуцированной нестероидными противовоспалительными препаратами. Бюллетень медицинских Интернет‐конференций. 2013; 3 (3). / Dudaeva N.G. Kliniko-morfologicheskaia kharakteristika enteropatii, indutsirovannoi nesteroidnymi protivovospalitel'nymi preparatami. Biulleten' meditsinskikh Internet‐konferentsii. 2013; 3 (3). [in Russian]
23. Кляритская И.Л., Балабанцева А.П., Фурсова В.А. Энтеропатии, индуцированные приемом нестероидных противовоспалительных препаратов. Кримський терапевтичний журн. 2014; 1: 38–44. / Kliaritskaia I.L., Balabantseva A.P., Fursova V.A. Enteropatii, indutsirovannye priemom nesteroidnykh protivovospalitel'nykh preparatov. Krims'kii terapevtichnii zhurn. 2014; 1: 38–44. [in Russian]
24. Reuter BK, Davies NM, Wallace JL. Nonsteroidal anti-inflammatory drug enteropathy in rats: role of permeability, bacteria, and enterohepatic circulation. Gastroenterology 1997; 112: 109–17.
25. Davies NM, Saleh JY, Skjodt NM. Detection and prevention of NSAID-induced enteropathy J Pharm Pharm Sci 2000; 3 (1): 137–55.
26. Damms A, Bischoff SC. Validation and clinical significance of a new calprotectin rapid test for the diagnosis of gastrointestinal diseases. Int J Colorectal Dis 2008; 23: 985–92.
27. Laine L, Connors LG, Reicin A et al. Serious lower gastrointestinal clinical events with nonselective NSAID or coxib use. Gastroenterology 2003; 124 (2): 288–92.
28. Endo H, Hosono K, Inamori M et al. Characteristics of small bowel injury in symptomatic chronic low-dose aspirin users: the experience of two medical centers in capsule endoscopy. J Gastroenterol 2009; 44: 544–9.
29. Endo H, Hosono K, Inamori M. Incidence of Small Bowel Injury Induced by Low-Dose Aspirin: A Crossover Study Using Capsule Endoscopy in Healthy Volunteers. Digestion 2009; 79: 44–51.
30. Maehata Y, Esaki M, Kochi S et al. Small bowel injury induced by selective cyclooxygenase-2 inhibitors: a prospective, double-blind, randomized clinical trial comparing celecoxib and meloxicam. J Gastroenterol 2012; 47 (4): 387–93.
31. Watari L, Oka S, Tanaka A et al. Comparison of small-bowel mucosal injury between low-dose aspirin and non-aspirin non-steroidal anti-inflammatory drugs: a capsule endoscopy study. Digestion 2014; 89 (3): 225–31.
32. Genta RM. Review article: the role of rebamipide in the management of inflammatory disease of the gastrointestinal tract. Aliment Pharmacol Ther 2003; 18: 8S–13S.
33. Mizukami K, Murakami K, Abe T et al. Aspirin-induced small bowel injuries and the preventive effect of rebamipide. World J Gastroenterol 2011; 17 (46): 5117–22.
34. Imaeda H, Fujimoto T, Takahashi K et al. Terminal-restriction fragment length polymorphism (T-RFLP) analysis for changes in the gut microbiota profiles of indomethacin- and rebamipide-treated mice. Digestion 2012; 86: 250–7.
35. Tanigawa T, Watanabe T, Otani K et al Rebamipide inhibits indomethacin-induced small intestinal injury: possible involvement of intestinal microbiota modulation by upregulation of alpha-defensin 5. Eur J Pharmacol 2013; 704: 64–9.
36. Watanabe T, Takeuchi T, Handa O. A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial of High-Dose Rebamipide Treatment for Low-Dose Aspirin-Induced Moderate-to-Severe Small Intestinal Damage. PLoS ONE. Doi: 10.1371/journal.pone.0122330 April 15, 2015.
37. Niwa Y, Nakamura M, Ohmiya N et al. Efficacy of rebamipide for diclofenac-induced small-intestinal mucosal injuries in healthy subjects: a prospective, randomized, double-blinded, placebo-controlled, cross-over study. J Gastroenterol 2008; 43 (4): 270–6.
38. Nishida U, Kato M, Nishida M et al. Evaluation of small bowel blood flow in healthy subjects receiving low-dose aspirin. World J Gastroenterol 2011; 17: 226–30.
39. Kurokawa S, Katsuki S, Fujita T et al. A randomized, double-blinded, placebo-controlled, multicenter trial, healing effect of rebamipide in patients with low-dose aspirin and/or non-steroidal anti-inflammatory drug induced small bowel injury. J Gastroenterol 2014; 49 (2): 239–44.
40. Fujimori S, Takahashi Y, Gudis K et al. Rebamipide has the potential to reduce the intensity of NSAID-induced small intestinal injury: a double-blind, randomized, controlled trial evaluated by capsule endoscopy. J Gastroenterol 2011; 46 (1): 57–64.
41. Zhang S, Qing Q, Bai Y et al. Rebamipide Helps Defend Against Nonsteroidal Anti-Inflammatory Drugs Induced Gastroenteropathy: A Systematic Review and Meta-Analysis. Dig Dis Sci 2013; 58 (7): 1991–2000.
________________________________________________
1. Nasonov L.B., Lazebnik, Iu.N., Belenkov E.L. i dr. Primenenie nesteroidnykh protivovospalitel'nykh preparatov: klinicheskie rekomendatsii. M.: Almaz, 2006. [in Russian]
2. Maev I.V., Samsonov A.A., Andreev D.N. Gastropatii, indutsirovannye nesteroidnymi protivovospalitel'nymi sredstvami: patogeneticheski obosnovannye podkhody k profilaktike i terapii. Farmateka. 2016; 2: 49–54. [in Russian]
3. Abdulganieva D.I., Salikhov I.G. Gastroenterologicheskie problemy pri revmaticheskikh zabolevaniiakh. Prakticheskaia meditsina. 2011; 1: 89–95. [in Russian]
4. Parfenov A.I. Enterologiia. M.: Triada- Х, 2002. [in Russian]
5. Karateev A.E., Nasonova V.A. Enteropatiia, indutsirovannaia nesteroidnymi, protivovospalitel'nymi preparatami. Terapevt. arkh. 2004; 2: 79–82. [in Russian]
6. Zagrebina E.A. Kliniko-funktsional'naia kharakteristika enteropatii, indutsirovannykh nesteroidnymi protivovospalitel'nymi preparatami. Avtoref. dis. … kand. med. nauk. Izhevsk, 2010. [in Russian]
7. Bjarnason I, Hayllar J, MacPherson AJ, Russell AS. Side effects of nonsteroidal anti-inflammatory drugs on the small and large intestine in humans. Gastroenterology 1993; 104: 1832–47.
8. Bjarnason I, Takeuchi K. Intestinal permeability in the pathogenesis of NSAID-induced enteropathy. J Gastroenterol 2009; 44 (Suppl. 19): 23–9.
9. Allison MC, Howatson AG, Torrance CJ et al. Gastrointestinal damage associated with the use of nonsteroidal antiinflammatory drugs. N Engl J Med 1992; 327: 751–6.
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Авторы
И.В.Маев, А.Н.Казюлин*
ГБОУ ВПО Московский государственный медико-стоматологический университет им. А.И.Евдокимова Минздрава России. 127473, Россия, Москва, ул. Делегатская, д. 20, стр. 1
*alexander.kazyulin@yandex.ru
ГБОУ ВПО Московский государственный медико-стоматологический университет им. А.И.Евдокимова Минздрава России. 127473, Россия, Москва, ул. Делегатская, д. 20, стр. 1
*alexander.kazyulin@yandex.ru
________________________________________________
I.V.Maev, A.N.Kazyulin*
A.I.Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation. 127473, Russian Federation, Moscow, ul. Delegatskaia, d. 20, str. 1
*alexander.kazyulin@yandex.ru
A.I.Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation. 127473, Russian Federation, Moscow, ul. Delegatskaia, d. 20, str. 1
*alexander.kazyulin@yandex.ru
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