SynthesisMedicine2026
Efficacy of rebamipide for the treatment of dry eye disease: An updated meta-analysis of randomized and non-randomized controlled trials.
Synthesis in Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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9 authors.
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Abstract
backgroundDry eye disease (DED) is a multifactorial ocular surface disorder characterized by tear film instability and inflammation. Rebamipide 2% ophthalmic suspension, a mucin secretagogue, has been investigated as a potential treatment due to its unique mechanism targeting mucin deficiency and ocular surface repair.
methodsA systematic search of PubMed, Embase, and Cochrane Library was conducted for studies published between January 2013 and March 2025. Non-randomized and randomized controlled trials evaluating topical 2% rebamipide in patients with DED were included. Outcomes assessed included tear breakup time, Schirmer I test, fluorescein staining scores, ocular surface disease index, and adverse events. Data were synthesized using standard meta-analytic techniques and subgroup analyses.
resultsThirteen studies, including both randomized and non-randomized trials, were analyzed, comprising a total of 575 participants. Meta-analysis showed that rebamipide nonsignificantly increased tear breakup time at 2 weeks (standardized mean difference [SMD] = 1.04; 95% confidence interval (CI):-0.94 to 3.03; P = .30; I2 = 89.3%), significant at 4 weeks (SMD = 1.19; 95% CI: 0.74-1.64; P < .0001; I2 = 85%) and nonsignificant at 12 weeks (SMD = 0.97; 95% CI:-0.15 to 2.08; P = .09; I2 = 80.1%) indicating enhanced tear film stability. Schirmer I test values showed no significant improvement (SMD = 0.04; 95% CI: -0.35-0.43; P = .83), suggesting limited effect on aqueous tear production. Fluorescein staining scores showed a reduction approaching statistical significance (SMD = -0.68; P = .051), while symptom scores measured by ocular surface disease index trended toward improvement, also approaching significance (SMD = -1.17; P = .055). Subgroup analyses revealed greater efficacy in contact lens wearers and postsurgical patients. Safety analysis indicated excellent tolerability, with a high adherence rate (96.8%) and only mild adverse effects such as dysgeusia and nasopharyngitis.
conclusionRebamipide 2% ophthalmic suspension improves tear stability and ocular surface health in mucin-deficient DED with a favorable safety profile. Further high-quality trials in diverse populations are warranted to confirm its role in global clinical practice.
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