Nonsteroidal anti-inflammatory drugs and statins have chemopreventative effects in patients with Barrett's esophagus.

Abstract:

BACKGROUND & AIMS:The incidence of Barrett's esophagus and esophageal adenocarcinoma has increased despite surveillance of patients with Barrett's esophagus. Limited data indicate that nonsteroidal anti-inflammatory drug (NSAID) and statin use reduce the risk for esophageal adenocarcinoma. We investigated whether NSAID or statin use reduces the risk of neoplastic progression from Barrett's esophagus. METHODS:We performed a prospective study of 570 patients with Barrett's esophagus at 3 academic and 12 regional Dutch hospitals. Information on medication use was collected in patient interviews at each surveillance visit and cross-checked with pharmacy records. Patients completed a questionnaire about use of over-the-counter medication. Incident cases of high-grade dysplasia and adenocarcinoma were identified during the follow-up period. RESULTS:During a median follow-up period of 4.5 years, 38 patients (7%) developed high-grade dysplasia or adenocarcinoma. After Barrett's esophagus had been diagnosed, 318 patients (56%) used NSAIDs for a median duration of 2 months, 161 (28%) used aspirin for a median duration of 5 years, 209 (37%) used statins for a median duration of 5 years, and 107 (19%) used NSAIDs and statins. NSAID and statin use were each associated with a reduced risk of neoplastic progression (hazard ratio [HR], 0.47; P = .030 and HR, 0.46; P = .048, respectively). Use of a combination of NSAIDs and statins increased the protective effect (HR, 0.22; P = .028). CONCLUSIONS:NSAID and statin use reduce the risk of neoplastic progression in patients with Barrett's esophagus. Use of a combination of NSAIDs and statins appears to have an additive protective effect.

journal_name

Gastroenterology

journal_title

Gastroenterology

authors

Kastelein F,Spaander MC,Biermann K,Steyerberg EW,Kuipers EJ,Bruno MJ,Probar-study Group.

doi

10.1053/j.gastro.2011.08.036

subject

Has Abstract

pub_date

2011-12-01 00:00:00

pages

2000-8; quiz e13-4

issue

6

eissn

0016-5085

issn

1528-0012

pii

S0016-5085(11)01219-4

journal_volume

141

pub_type

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