NSAIDs and Statins Might Have Chemopreventive Potential for Barrett Esophagus

Home>
Specialties>
Gastroenterology>
Summary and Comment

NSAIDs and Statins Might Have Chemopreventive Potential for Barrett Esophagus

In an observational study, use of the two drugs together greatly reduced the risk for neoplastic progression.

Some studies suggest that patients with Barrett esophagus can reduce their risk for adenocarcinoma or high-grade dysplasia by taking nonsteroidal anti-inflammatory drugs (NSAIDs) or statins, but the evidence to date is limited. To further evaluate this possibility, investigators prospectively studied patients with Barrett esophagus at 15 hospitals in the Netherlands. Medication use was self-reported and validated using pharmacy records. Endoscopic surveillance was performed according to published guidelines.

During a median follow-up of 4.5 years, 38 of the 570 patients (7%) developed esophageal cancer or high-grade dysplasia. NSAID use and statin use were independently associated with a reduced risk for neoplastic progression (hazard ratio for any use $≥$ 1 month, 0.47 and 0.46); however, the effect was greatest when the two drug classes were combined (HR, 0.22). The use of low-dose aspirin did not affect risk. The authors concluded that NSAIDs and statins reduce the risk for neoplastic progression in patients with Barrett esophagus and that combined therapy has an additive effect.

Comment: Given the observational nature of this study, we cannot rule out the possibility that the observed associations are related to the reasons why patients were taking NSAIDs or statins. Nonetheless, the data are strong enough to warrant further study on the chemoprotective effects of these drugs.

— David J. Bjorkman, MD, MSPH (HSA), SM (Epid.)

Published in Journal Watch Gastroenterology January 13, 2012

Citation(s):

Kastelein F et al. Nonsteroidal anti-inflammatory drugs and statins have chemopreventative effects in patients with Barrett's esophagus. Gastroenterology 2011 Dec; 141:2000.

Medline abstract (Free)

Your Remark:

Reader Remarks are intended to encourage lively discussion of clinical topics with your peers in the medical community. We ask that you keep your remarks to a reasonable length, and we reserve the right to withhold publication of remarks that do not meet this standard.

The editors of Journal Watch may respond to Reader Remarks, but we cannot promise to respond to a particular remark.

Remark subject:*

Your remark:*

Fields marked with an * are required.

Name as you'd like it to appear:
First & middle initial:*

Last:*

Email address (will not
be published):*

Professional specialty:*

Place of work (optional):

Submitting a comment indicates you have read and agreed to the remark guidelines and declare:*

No competing interests

Or, the following competing interests (for example, financial stakes or professional relationships):

PRIVACY: We will not use your email address, submitted for a comment, for any other purpose nor sell, rent, or share your e-mail address with any third parties. Please see our Privacy Policy.

CLEAR erases anything you've added in any part of the form. CONTINUE allows you to check your entire post (and edit it if necessary) before submitting.

To ensure that your Reader Remark is not formatted as one long paragraph, precede new paragraphs with either a blank line or an indentation.