The use of nonsteroidal anti-inflammatory drugs and the risk of Barrett's oesophagus

Thrift, A. P., Pandeya, N., Smith, K. J., Green, A. C., Webb, P. M. and Whiteman, D. C. (2011) The use of nonsteroidal anti-inflammatory drugs and the risk of Barrett's oesophagus. Alimentary Pharmacology and Therapeutics, 34 10: 1235-1244. doi:10.1111/j.1365-2036.2011.04855.x


Author Thrift, A. P.
Pandeya, N.
Smith, K. J.
Green, A. C.
Webb, P. M.
Whiteman, D. C.
Title The use of nonsteroidal anti-inflammatory drugs and the risk of Barrett's oesophagus
Journal name Alimentary Pharmacology and Therapeutics   Check publisher's open access policy
ISSN 0269-2813
1365-2036
Publication date 2011-11
Sub-type Article (original research)
DOI 10.1111/j.1365-2036.2011.04855.x
Volume 34
Issue 10
Start page 1235
End page 1244
Total pages 10
Place of publication Oxford, United Kingdom
Publisher Wiley-Blackwell Publishing
Collection year 2012
Language eng
Formatted abstract
Background  Epidemiological studies have consistently reported inverse associations between nonsteroidal anti-inflammatory drugs (NSAIDs) and oesophageal adenocarcinoma, but few have investigated associations with the precursor lesion, Barrett’s oesophagus.
Aim  To investigate the relationship between NSAID use and risk of Barrett’s oesophagus.
Methods  We conducted a 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. We calculated odds ratios (ORs) and 95% CIs using unconditional logistic regression.
Results  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 we 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. We found no evidence that aspirin or non-aspirin NSAID use conferred risk reductions for dysplastic Barrett’s oesophagus, regardless of the control series. We excluded effect modification by known risk factors as an explanation for these null findings.
Conclusions  We found little support for an inverse association between use of NSAIDs and Barrett’s oesophagus. The question of whether or not these medications prevent the onset of Barrett’s oesophagus remains open.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Public Health Publications
 
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