PMID- 20188100
OWN - NLM
STAT- MEDLINE
DCOM- 20100701
LR  - 20211020
IS  - 1528-0012 (Electronic)
IS  - 0016-5085 (Print)
IS  - 0016-5085 (Linking)
VI  - 138
IP  - 7
DP  - 2010 Jun
TI  - Medications (NSAIDs, statins, proton pump inhibitors) and the risk of esophageal 
      adenocarcinoma in patients with Barrett's esophagus.
PG  - 2260-6
LID - 10.1053/j.gastro.2010.02.045 [doi]
AB  - BACKGROUND & AIMS: Limited evidence suggests that proton pump inhibitors (PPI), 
      nonsteroidal anti-inflammatory drugs (NSAID)/aspirin, and statins may be 
      associated with a low risk of esophageal neoplasia. However, the possible effect 
      these medications may have on the risk of esophageal adenocarcinoma (EAC) in 
      patients with existing Barrett's esophagus (BE) is unclear. METHODS: We conducted 
      a nested case-control study in a cohort of patients with BE identified in the 
      national Department of Veterans' Affairs computerized databases. Cases with 
      incident EAC were matched by incidence density sampling to controls with BE who 
      remained without EAC at the date of the EAC diagnosis for the corresponding case. 
      We identified prescriptions for PPI, NSAIDs/aspirin, and statins that were filled 
      between BE diagnosis and EAC diagnosis. Incidence density ratios were calculated 
      using conditional logistic regression models that adjusted for race, outpatient 
      encounters, a disease comorbidity index, and socioeconomic status. RESULTS: In a 
      cohort of 11,823 patients with first-time BE diagnosis, we examined 116 EAC cases 
      and 696 matched controls. Most cases and controls had at least one filled PPI 
      prescription (95% vs 94%; P = .5). In this setting of almost universal PPI use, 
      filled NSAID/aspirin prescriptions were associated with a reduced risk of EAC 
      (adjusted incidence density ratio, 0.64; 95% confidence interval, 0.42-0.97). 
      Filled statin prescriptions also were associated with a reduction in EAC risk 
      (0.55; 95% confidence interval, 0.36-0.86), with a significant trend toward 
      greater risk reduction with longer duration of statin use. However, the strong 
      inverse associations with even short periods of use raise concerns of 
      uncontrolled confounding. CONCLUSIONS: This observational study indicates that in 
      patients with BE using PPI, NSAID/aspirin, or statin therapy might reduce the 
      risk of developing EAC.
CI  - Copyright 2010 AGA Institute. Published by Elsevier Inc. All rights reserved.
FAU - Nguyen, Dang M
AU  - Nguyen DM
AD  - Section of Gastroenterology and Section of Health Services Research, Houston 
      Department of Veterans Affairs Medical Center and Baylor College of Medicine, 
      Houston, Texas, USA.
FAU - Richardson, Peter
AU  - Richardson P
FAU - El-Serag, Hashem B
AU  - El-Serag HB
LA  - eng
GR  - P50 DK56338/DK/NIDDK NIH HHS/United States
GR  - K24DK078154-03/DK/NIDDK NIH HHS/United States
GR  - P30 DK056338/DK/NIDDK NIH HHS/United States
GR  - K24 DK078154/DK/NIDDK NIH HHS/United States
GR  - K24 DK078154-03/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, U.S. Gov't, Non-P.H.S.
DEP - 20100223
PL  - United States
TA  - Gastroenterology
JT  - Gastroenterology
JID - 0374630
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
RN  - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Adenocarcinoma/*prevention & control
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Anti-Inflammatory Agents, Non-Steroidal/*therapeutic use
MH  - Barrett Esophagus/*complications
MH  - Case-Control Studies
MH  - Esophageal Neoplasms/*prevention & control
MH  - Female
MH  - Humans
MH  - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Proton Pump Inhibitors/*therapeutic use
PMC - PMC2883678
MID - NIHMS181808
COIS- There is no conflict of interest.
EDAT- 2010/03/02 06:00
MHDA- 2010/07/02 06:00
PMCR- 2011/06/01
CRDT- 2010/03/02 06:00
PHST- 2009/06/29 00:00 [received]
PHST- 2010/01/29 00:00 [revised]
PHST- 2010/02/11 00:00 [accepted]
PHST- 2010/03/02 06:00 [entrez]
PHST- 2010/03/02 06:00 [pubmed]
PHST- 2010/07/02 06:00 [medline]
PHST- 2011/06/01 00:00 [pmc-release]
AID - S0016-5085(10)00308-2 [pii]
AID - 10.1053/j.gastro.2010.02.045 [doi]
PST - ppublish
SO  - Gastroenterology. 2010 Jun;138(7):2260-6. doi: 10.1053/j.gastro.2010.02.045. Epub 
      2010 Feb 23.