Yoshida Study Good day doctor/s! First, let me thank you for giving me the opportunity to discuss with you another important topic that can be useful in your daily practice. Today I would like to impart to you the role of Mucosta in synergism with proton-pump inhibitors in addressing the recurrence of GERD symptoms.

Recurrence rate of GERD Proton pump inhibitors (PPIs) are effective in healing reflux esophagitis and relieving the symptoms of GERD as proven in various clinical trials, however GERD relapse and recurrence of symptoms during maintenance stage is observed. The rate of recurrence of esophagitis with lansoprazole is reported to be about 10–30% with maintenance therapy over 24–48 weeks. Ref) Yoshisa N. et al. Dig Dis Sci 2010; 55(12): 3393-8

[Until recurrence of symptoms ] YOSHIDA Study II. Clinical study Management of Recurrence of symptoms of Gastroesophageal Reflux Disease: Synergistic Effect of Rebamipide with 15mg Lansoprazole. Methods Study design : Open-label, two phase study (initial healing phase + randomized maintenance phase. Objective : To investigate the effects of rebamipide, a mucosal protective anti-ulcer agent, on recurrence of reflux symptoms during PPI maintenance therapy. Initial healing phase Maintenance phase Lansoprazole 15mg Lansoprazole 30mg or omeprazole 20mg or rabeprazole 10mg Patients who obtained symptomatic relief (Less than 4 points on GSRS) Randomization With this, we wanted to show you the management of Recurrence of symptoms of Gastroesophageal Reflux Disease through Synergistic Effect of Rebamipide with 15mg Lansoprazole. This is an Open-label, two phase study (initial healing phase + randomized maintenance phase) Initial healing phase is Lansoprazole 30mg or omeprazole 20mg or rabeprazole 10mg. Patients who obtained symptomatic relief was randomized to either take Lanzoprazole or lanzoprazole + Rebamipide. Lansoprazole 15mg + rebamipide 300mg [ 8weeks ] [ 12 months] or [Until recurrence of symptoms ] * Criteria for Recurrence : Recurrence was define as patient report of recurrence of symptoms with a score of five points or higher on the GSRS questionnaire. Ref) Yoshisa N. et al. Dig Dis Sci 2010; 55(12): 3393-8

Yoshida Study II. Clinical study Results Effect of rebamipide on PPI maintenance therapy Group Total patients Relapse within 12 months Relapse rate (%) Lansoprazole (15mg/day) 21 11 52.4* +Rebamipide (300mg/day) 20 4 20.0* Rebamipide in combination with PPI significantly decreased recurrence of symptoms in GERD patients * P < 0,05, statistically significant All recurrences in the lansoprazole 15mg group were noted within 6 months. None of the patients reported any adverse effects during the study Ref) Yoshisa N. et al. Dig Dis Sci 2010; 55(12): 3393-8

Yoshida Study II. Clinical study Results Results showed that IL-8 expression level in the esophageal mucosa of patients with rebamipide was significantly decreased compared with that of patients without rebamipide Ref) Yoshisa N. et al. Dig Dis Sci 2010; 55(12): 3393-8

Buy 25 tablets and get 15 tablets free Patients buy 25 tablets to drugstores and keeps the receipt Patient gets in touch OTSUKA ONE QUEST hotline: Patient sends a copy of receipt to thru text /viber. OR Patients mail the copy of the receipt to OTSUKA ONE QUEST. OTSUKA ONEQUEST will send the free tablets to patients via mail Let me remind you of Otsuka’s ONE QUEST patient program. Your patients can now enjoy bigger savings when they buy Rebamipide Mucosta. For every purchase of 25 tablets, your patients can get free 15 tablets. They just have to keep the receipts and call the Otsuka ONE QUEST hotline for the details of the program. ONE QUEST will immediately mail the free tablets to patient upon receipt of the proof of purchase.

Otsuka’S Novel Education for Quality, Efficacy and Safety Good morning/afternoon/evening, Doctor! I am very happy to inform you that we have just upgraded ONE Quest website. (click to show the text) Just for a recap, ONE Quest, which stands for Otsuka’s Novel Education for Quality, Efficacy and Safety, is our holistic Patient Wellness Program which covers the entire treatment cycle from pre-treatment, diagnosis, to treatment and post treatment. This time, we have enhanced our ONE Quest website to serve patients better, and... (click to show the image) ...to achieve Patient Well-being and foster patient Empowerment.

ONE Quest Website – New Features One with you in wellness PATIENT PROGRAMS DISEASES MD’S CORNER USER-FRIENDLY INTERFACE Here are the main features of our new ONE Quest website. (click to show the first image) 1) PATIENT PROGRAMS We provide updates on our patient program and patient support services at PATIENT PROGRAMS. Patients can also find our upcoming event details and past event archives at NEWS & EVENTS and this will be regularly updated. (click to show the second image) 2) DISEASES To promote patients’ better understanding of health and diseases, we enhanced the DISEASES section per organ per disease, such as xxx under XXX and yyy under YYY (*see below for specific diseases). These answer basic questions on the disease(s) and provide health tips in easy-to-understand plain words. *Brain – MDD, Bipolar, Schizophrenia, Stroke *Heart – Congestive Heart Failure, Coronary Angioplasty *Lungs – Asthma, Acute Bronchitis *Stomach – Ulcer, Gastritis *Liver – Cirrhosis, Hepatic Encephalopathy *Others – PAD, Hyponatremia (click to show the third image) 3) MD’S CORNER Next is MD’S CORNER, which contains articles by doctors to help educate and empower patients. We will be happy if you could also share your experience with us and patients in this portion. (click to show the fourth image) 4) USER-FRIENDLY INTERFACE To make it more user-friendly and for easy reading, our new ONE Quest website is designed to adjust itself to look good on all devices from desktop computers to smartphones. You don’t need to resize or scroll a lot to read the contents anymore. We hope that all these new features will serve patients’ needs and benefit them. (click to show the images and texts) Doctor, Your patient is Our concern. We are ONE with you in Patient Wellness with ONE Quest at www.onequest.com.ph For any concerns on the website or program, our call center agents are ready to assist you. Thank you very much for your time! One with you in wellness www.onequest.com.ph