Nonsteroidal anti-inflammatory drugs prevent gastric cancer associated with the use of proton pump inhibitors after Helicobacter pylori eradication

被引:7
作者
Arai, Junya [1 ]
Niikura, Ryota [1 ,5 ]
Hayakawa, Yoku [1 ]
Sato, Hiroki [1 ]
Kawahara, Takuya [2 ]
Honda, Tetsuro [6 ]
Hasatani, Kenkei [7 ]
Yoshida, Naohiro [8 ]
Nishida, Tsutomu [9 ]
Sumiyoshi, Tetsuya [10 ]
Kiyotoki, Shu [11 ]
Ikeya, Takashi [3 ]
Arai, Masahiro [4 ]
Suzuki, Nobumi [1 ]
Tsuji, Yosuke [1 ]
Yamada, Atsuo [1 ]
Koike, Kazuhiko [1 ]
机构
[1] Univ Tokyo, Grad Sch Med, Dept Gastroenterol, Bunkyo City, Japan
[2] Univ Tokyo Hosp, Clin Res Promot Ctr, Bunkyo City, Japan
[3] St Lukes Int Hosp, Dept Gastroenterol, Chuo Ku, Tokyo, Japan
[4] Nerima Hikarigaoka Hosp, Dept Gastroenterol, Nerima Ku, Tokyo, Japan
[5] Tokyo Med Univ, Dept Gastroenterol Endoscopy, Shinjuku Ku, Tokyo, Japan
[6] Nagasaki Harbor Med Ctr, Dept Gastroenterol, Nagasaki, Nagasaki, Japan
[7] Fukui Prefectural Hosp, Dept Gastroenterol, Fukui, Fukui, Japan
[8] Ishikawa Prefectural Cent Hosp, Dept Gastroenterol, Kanazawa, Ishikawa, Japan
[9] Toyonaka City Hosp, Dept Gastroenterol, Toyonaka, Osaka, Japan
[10] Tonan Hosp, Dept Gastroenterol, Sapporo, Hokkaido, Japan
[11] Shuto Gen Hosp, Dept Gastroenterol, Yanai, Yamaguchi, Japan
来源
JGH OPEN | 2021年 / 5卷 / 07期
关键词
COX2; inhibitors; gastric cancer; Helicobacter pylori; NSAIDs; proton pump inhibitor; SELECTIVE CYCLOOXYGENASE-2 INHIBITOR; RISK;
D O I
10.1002/jgh3.12583
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background and Aim: Proton pump inhibitors (PPIs) are a potential cause of gastric carcinogenesis after Helicobacter pylori eradication. Thus, appropriate management including chemoprevention is required. The aim of this study was to evaluate the association between nonsteroidal anti-inflammatory drugs (NSAIDs) and the incidence of post-eradication gastric cancer in PPI users. Methods: A multicenter retrospective cohort study was conducted. Patients who used a PPI (>= 30 days) after H. pylori eradication between 2014 and 2019 were analyzed in nine hospital databases. Gastric cancer incidence was a primary outcome, and their association with NSAIDs use and clinical factors was evaluated. Hazard ratios were adjusted by age, sex, smoking, and Charlson Comorbidity Index. Results: During the mean follow-up period of 2.38 years, 1.13% (31/2431) of all patients developed gastric cancer. The cumulative incidence of gastric cancer in PPI users was 0.25% at 1 year, 0.51% at 3 years, and 1.09% at 5 years in the NSAID users and 0.89% at 1 year, 2.32% at 3 years, and 3.61% at 5 years in nonusers. NSAIDs were associated with a lower gastric cancer risk (adjusted hazard ratio = 0.28, P = 0.005). No gastric cancer was observed in the cyclooxygenase-2 inhibitor users (n = 256). NSAID use with high dose and long duration was significantly associated with a lower incidence of gastric cancer. Conclusion: NSAIDs were associated with a 60% decrease in the gastric cancer incidence in H. pylori-eradicated PPI users, with dose and duration response effects. NSAIDs may be effective for chemoprevention against PPI-related gastric cancer.
引用
收藏
页码:770 / 777
页数:8
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