Dataset Information
NSAIDs, statins, low-dose aspirin and PPIs, and the risk of oesophageal adenocarcinoma among patients with Barrett's oesophagus: a population-based case-control study.
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ABSTRACT: Objectives
Non-steroidal anti-inflammatory drugs (NSAIDs), proton pump inhibitors (PPIs), low-dose aspirin and statins may decrease the risk of oesophageal adenocarcinoma (OAC) among patients with Barrett's oesophagus (BO). However, previous studies did not adequately address bias and confounding. Our objective was to estimate the risk of OAC among patients with BO exposed to NSAIDs, statins and PPIs.Design
Case-control study nested within a BO cohort.Setting
Two primary care databases (the UK and the Netherlands (NL)).Participants
Cases were adults ?18?years of age with OAC or high-grade dysplasia (HGD) diagnosis ?1?year after BO diagnosis. Controls were matched on age, sex, year of BO diagnosis and database.Exposure
Drug use was assessed from BO diagnosis until matching date.Outcome measure
Adjusted ORs with 95% CI were calculated by conditional logistic regression.Results
Within the BO cohort (n=15?134), 45 OAC (UK: 40, NL: 5) and 12 HGD cases (NL: 12) were identified. ORa for OAC during NSAID use was 1.2 (95% CI 0.6 to 2.5) and during statin use for >3?years 0.5 (95% CI 0.1 to 1.7). When including HGD cases (n=57), ORa for NSAID use was 0.9 (95% CI 0.5 to 1.8) and for statin use >3?years 0.5 (95% CI 0.1 to 1.7). Higher doses of statins showed lower estimates for OAC and HGD, though not statistically significant. Low-dose aspirin and PPIs did not significantly decrease the risk of OAC and HGD.Conclusions
In this population-based nested case-control study, use of NSAIDs, PPIs, low-dose aspirin or statins did not reduce the risk of HGD and OAC among patients with BO. These findings indicate that for an unselected group of patients with BO chemoprevention by use of drugs to reduce progression to HGD and OAC should not be directly considered as routine care.
SUBMITTER: Masclee GM
PROVIDER: S-EPMC4316430 | biostudies-literature | 2015 Jan
REPOSITORIES: biostudies-literature
Publications
NSAIDs, statins, low-dose aspirin and PPIs, and the risk of oesophageal adenocarcinoma among patients with Barrett's oesophagus: a population-based case-control study.
BMJ open 20150129 1
<h4>Objectives</h4>Non-steroidal anti-inflammatory drugs (NSAIDs), proton pump inhibitors (PPIs), low-dose aspirin and statins may decrease the risk of oesophageal adenocarcinoma (OAC) among patients with Barrett's oesophagus (BO). However, previous studies did not adequately address bias and confounding. Our objective was to estimate the risk of OAC among patients with BO exposed to NSAIDs, statins and PPIs.<h4>Design</h4>Case-control study nested within a BO cohort.<h4>Setting</h4>Two primary ...[more]
