Efficacy and safety of Rebamipide in the treatment of dry eye disease: a systematic review and meta-analysis

To evaluate the efficacy and safety of rebamipide 1% and 2% in the management of dry eye disease (DED) compared to placebo or artificial tears (My Tears, Sodium Hyaluronate, or Diquafosol). Systematic review and meta-analysis. This meta-analysis, adhering to PRISMA 2020 guidelines, systematically reviewed randomized controlled trials evaluating the efficacy of rebamipide, a medication known for gastric ulcer treatment, as an treatment for DED. A comprehensive literature search encompassed various databases. Inclusion criteria focused on high-quality evidence, namely RCTs, with a primary focus on outcomes such as tear film break-up time (TBUT), fluorescein staining score (FCS), and lissamine green conjunctival staining (LGCS) score. Thirteen studies were included, with diverse outcomes reported at 2, 4, and 8-12 weeks. Rebamipide demonstrated significant improvement compared to the control group in TBUT (MD = 0.47, 95% CI [0.15 to 0.79]), FCS (MD = -1.17, 95% CI [-1.81 to -0.53]), LGCS (MD = -1.73, 95% CI [-2.53 to -0.93]), and Schirmer’s test (MD = 1.05, 95% CI [0.16 to 1.95]). The overall risk ratio for adverse events favored the control group (RR = 1.39, 95% CI [1.10 to 1.77], P = 0.21). Rebamipide is emerging as an effective treatment for DED, demonstrating improvements in various outcome measures. This meta-analysis provides valuable insights for all clinicians and researchers supporting informed decision-making and guiding future research endeavors in the management of DED.