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rabeprazole + aspirin + clopidogrel refers to a therapeutic regimen evaluated in a randomized clinical trial (NCT00927459) conducted by Taipei Veterans General Hospital. The study investigated the management of patients with aspirin-associated peptic ulcer disease (PUD) who required ongoing antiplatelet therapy for cardiovascular disease prevention. The regimen involves the use of rabeprazole, a proton pump inhibitor (PPI) that irreversibly inhibits the gastric H+/K+-ATPase enzyme system, in combination with either aspirin or clopidogrel. Aspirin acts by irreversibly inhibiting cyclooxygenase-1 (COX-1) and COX-2 enzymes, thereby reducing thromboxane A2 production, while clopidogrel is a thienopyridine prodrug whose active metabolite irreversibly antagonizes the P2Y12 ADP receptor on platelets. The trial specifically compared the ulcer healing rates of rabeprazole plus aspirin versus rabeprazole plus clopidogrel, finding that the aspirin-based combination was non-inferior for healing aspirin-related peptic ulcers when co-administered with a PPI.
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