The use of nonsteroidal anti-inflammatory drugs and the risk of Barretts oesophagus
Alimentary Pharmacology and Therapeutics, 10/11/2011
Thrift AP et al. – Little support for an inverse association between use of nonsteroidal anti–inflammatory drugs(NSAIDs) and Barrett’s oesophagus. The question of whether or not these medications prevent the onset of Barrett’s oesophagus remains open.Methods
- Large population-based case-control study that collected information on patterns of intake for aspirin and non-aspirin NSAIDs during the past 5 years and other exposures from 285 patients with nondysplastic Barrett’s oesophagus, 108 patients with dysplastic Barrett’s oesophagus, and two separate control groups: 313 endoscopy patients with acute inflammatory changes (‘inflammation controls’) and 644 population controls was conducted.
- Odds ratios (ORs) and 95% CIs using unconditional logistic regression were calculated.
- Use of aspirin was not associated with nondysplastic Barrett’s oesophagus when compared with population (OR=1.01, 95% CI 0.71–1.43) or inflammation controls (OR=1.16, 95% CI 0.80–1.68).
- Whereas the authors observed significant risk reductions for use of non-aspirin NSAIDs when nondysplastic Barrett’s oesophagus cases were compared with population controls (OR=0.69, 95% CI 0.49–0.97), the effect was weaker and nonsignificant when cases were compared with inflammation controls (OR=0.82, 95% CI 0.57–1.18), and no dose-response effects were present in either analysis.
- No evidence that aspirin or non-aspirin NSAID use conferred risk reductions for dysplastic Barrett’s oesophagus, regardless of the control series was found.
- The authors excluded effect modification by known risk factors as an explanation for these null findings.