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Medication Usage and the Risk of Neoplasia in Patients With Barrett's Esophagus
Open accessAbstract
Background & aims Experimental evidence indicates that proton pump inhibitors (PPIs), nonsteroidal anti-inflammatory drugs (NSAIDs)/aspirin, and statins can protect patients with Barrett's esophagus (BE) from developing neoplasias. However, only limited data are available on chemoprevention in patients with BE.Methods A retrospective observational study was performed using data from patients with documented BE. Prescription information was collected from pharmacy records. Cox regression analyses were performed to examine the association between prescriptions for PPIs, NSAIDs/aspirin, or statins and the risk of developing esophageal dysplasia or adenocarcinoma during follow-up (from 1982 to 2005).Results We examined 344 patients diagnosed with BE (mean age 61 years, 90.4% Caucasian, 94.2% male). After BE diagnosis, 67.2% of the patients were prescribed PPIs for a mean duration of 5.1 years; 49.1% were prescribed NSAIDs for a mean duration of 3.6 years, and 25.3% were prescribed statins for a mean duration of 2.8 years. During 2620 patient-years, high grade dysplasia or esophageal adenocarcinoma developed in 33 patients. PPI treatment after BE diagnosis was associated with a reduced risk of high grade dysplasia or cancer; this association persisted after adjustment for gender, age, and the length of BE. NSAID and/or aspirin therapy were associated with a nonsignificant trend toward lower incidence of high grade dysplasia or esophageal cancer.Conclusions PPI therapy reduces the risk of neoplasms in patients with BE. NSAIDs/aspirin appear to reduce cancer risk whereas statin use is not significantly associated with the risk of neoplasia in patients with BE.
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“because their long-term use significantly decreases the risk of the progression to high-grade dysplasia and EAC[50-52]”
From Proton pump inhibitors and dysbiosis: current knowledge and aspects to be clarified (2019) · cites this paper as [51]
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Chemoprevention of esophageal adenocarcinoma
Snider, E. J., Kaz, A. M., Inadomi, J. M., & Grady, W. M. (2020) · Gastroenterology report · doi:10.1093/gastro/goaa040 · Cited by 15
Ko, M. T., Thomas, T. R., Holden, E., Beales, I., & Alexandre, L. (2024) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2024.07.041 · Cited by 18
Gastrointestinal pharmacology: practical tips for the esophagologist
Scarpignato, C., Sloan, J. A., Wang, D. H., & Hunt, R. H. (2020) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.14447 · Cited by 14
Chemoprevention in Barrett's Esophagus: A Pill a Day?
Jankowski, J. A., & Hooper, P. A. (2010) · Gastrointestinal Endoscopy Clinics of North America · doi:10.1016/j.giec.2010.09.005 · Cited by 13
Scholl, S., Dellon, E. S., & Shaheen, N. J. (2011) · The American Journal of Gastroenterology · doi:10.1038/ajg.2010.409 · Cited by 12
Rajendra, S., & Sharma, P. (2012) · Therapeutic Advances in Gastroenterology · doi:10.1177/1756283x12446668 · Cited by 11
“Conversely, in a nested case control study involving 11,823 patients with a first-time BO diagnosis (116 with incident OA and 696 matched controls without OA) there was no dose–response effect of PPIs on the prevention of progression to OA [Nguyen et al. 2010].”
BackgroundOptimal management of Barrett's esophagus: pharmacologic, endoscopic, and surgical interventions
Konda, V. J. A., & Dalal (2011) · Therapeutics and Clinical Risk Management · doi:10.2147/tcrm.s23425 · Cited by 10
“1%).(19) It is unclear where in the metaplasiadysplasia-esophageal adenocarcinoma sequence that PPIs may exert their greatest effect, but there is some evidence that PPIs may delay progression from metaplasia to dysplasia.”
Yao, H., Wang, L., Li, H., Xu, S., Bai, Z., Wu, Y., Chen, H., Goyal, H., & Qi, X. (2021) · Expert Review of Clinical Pharmacology · doi:10.1080/17512433.2022.2008909 · Cited by 10
Role of chemoprophylaxis with either NSAIDs or statins in patients with Barrett’s esophagus
Tsibouris, P. (2014) · World Journal of Gastrointestinal Pharmacology and Therapeutics · doi:10.4292/wjgpt.v5.i1.27 · Cited by 9
Neu erkannte Nebenwirkungen von Protonenpumpeninhibitoren: Argumente Pro Fundoplicatio bei GERD?
von Rahden, B. H. A., Scheurlen, M., Filser, J., Stein, H. J., & Germer, C.-T. (2012) · Der Chirurg · Cited by 9
Aspirin Use is Associated with Lower Risk of Barrett's Esophagus in Women
Jovani, M., Cao, Y., Feskanich, D., Hur, C., Jacobson, B. C., & Chan, A. T. (2017) · Gastroenterology · doi:10.1016/s0016-5085(17)30692-3 · Cited by 9
Huang, J., Liu, H., Sun, T., Fang, J., Wang, J., & Xiong, H. (2019) · Clinical Science · doi:10.1042/cs20180828 · Cited by 9
Barrett Esophagus and Intramucosal Esophageal Adenocarcinoma
Rajendra, S., & Sharma, P. (2017) · Hematology/Oncology Clinics of North America · doi:10.1016/j.hoc.2017.01.003 · Cited by 8
Evaluation and Management of Premalignant Conditions of the Esophagus
Ramai, D., Lai, J., Ofori, E., Linn, S., & Reddy, M. (2019) · Journal of Clinical Gastroenterology · doi:10.1097/mcg.0000000000001247 · Cited by 8
Peura, D. A., & Wilcox, C. M. (2014) · Postgraduate Medicine · doi:10.3810/pgm.2014.01.2728 · Cited by 8
Goldberg, A., Gerkin, R. D., & Young, M. A. (2015) · Digestive Diseases and Sciences · doi:10.1007/s10620-015-3569-0 · Cited by 8
Statins as Potential Therapeutics for Esophageal Cancer
Hassanabad, A. F., & Wong, J. V. S. (2021) · Journal of Gastrointestinal Cancer · doi:10.1007/s12029-021-00648-4 · Cited by 8
“Nevertheless, there is also evidence that statins may not prevent the progression of BE to EAC [22].”
BackgroundRajendra, S., & Sharma, P. (2014) · Current Treatment Options in Gastroenterology · doi:10.1007/s11938-014-0012-0 · Cited by 8
Kasiri, K., Sherwin, C. M. T., Rostamian, S., & Heidari-Soureshjani, S. (2023) · Current Therapeutic Research · doi:10.1016/j.curtheres.2023.100692 · Cited by 8
Chemoprevention of Gastrointestinal Neoplasia
Half, E., & Arber, N. (2013) · Current Gastroenterology Reports · doi:10.1007/s11894-013-0320-x · Cited by 8
“In a second study of 344 BE patients, NSAID use was associated with a reduction in the incidence of HGD or EAC, although it did not reach statistical significance [37].”
Statin use and the risk of esophageal cancer: a population-based case-control study
Chan, T., Chiu, H., Wu, C., Lin, C., & Yang, C. (2013) · Expert Opinion on Drug Safety · doi:10.1517/14740338.2013.778241 · Cited by 8
“While this finding is not consistent with the direction of the association (inverse) reported in five observation studies [16-20], there are mechanisms by which statins might increase cancer risk.”
ResultData to Guide the “Test and Treat Era” of Hepatitis C
Ward, J. W., Rein, D. B., & Smith, B. D. (2012) · Gastroenterology · doi:10.1053/j.gastro.2012.08.027 · Cited by 8
Li, L., Cao, Z., Zhang, C., Geng, X., Wang, J., Pan, W., & Jing, J. (2021) · Translational Cancer Research · doi:10.21037/tcr-20-3362 · Cited by 7
“A total of 8 studies (3 cohort studies and 5 case-control studies) comprising 7,053 patients were included (2,11-17).”
BackgroundLow grade dysplasia in Barrett’s esophagus: Should we worry?
Jagadesham, V. P., & Kelty, C. (2014) · World Journal of Gastrointestinal Pathophysiology · doi:10.4291/wjgp.v5.i2.91 · Cited by 7
Metadata
- Authors
- Nguyen, D. M., El-Serag, H. B., Henderson, L., Stein, D., Bhattacharyya, A., & Sampliner, R. E.
- Affiliations
- Michael E. DeBakey VA Medical Center (US)
- University of Arizona (US)
- Venue
- Clinical Gastroenterology and Hepatology
- Publisher
- Elsevier BV
- Published
- 2009-12
- Volume
- 7
- Issue
- 12
- Pages
- 1299-1304
- ISSN
- 1542-3565 (ISSN-L)
- PMC
- PMC2789910
- OpenAlex
- W2071302779
- Cited by
- 159
- References
- 20
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 7 · 2022: 4 · 2021: 13 · 2020: 4 · 2019: 8 · 2018: 4 · 2017: 9 · 2016: 4 · 2015: 15 · 2014: 15 · 2013: 17 · 2012: 25
- FWCI
- 18.20
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Gastroenterology and Hepatology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (R01CA116845)
- National Institute of Diabetes and Digestive and Kidney Diseases (K24DK078154, DK 563338)
- Topics
- Health Sciences › Medicine › Surgery › Esophageal Cancer Research and Treatment
- Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
- Health Sciences › Medicine › Surgery › Esophageal and GI Pathology
- Keywords
- Barrett's esophagus, proton pump inhibitors, nonsteroidal anti-inflammatory drugs, aspirin, statins, chemoprevention, esophageal adenocarcinoma, high-grade dysplasia, neoplasia risk, medication use
- MeSH terms
- Aged, Anti-Inflammatory Agents, Non-Steroidal, Barrett Esophagus, Esophageal Neoplasms, Female, Humans, Male, Middle Aged, Retrospective Studies, Risk Factors, Drug Monitoring, Proton Pump Inhibitors
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