Nonsteroidal anti‐inflammatory drugs prevent gastric cancer associated with the use of proton pump inhibitors after Helicobacter pylori eradication
Abstract 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‐inflamm...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-07-01
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| Series: | JGH Open |
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| Online Access: | https://doi.org/10.1002/jgh3.12583 |
| _version_ | 1818580926345510912 |
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| author | Junya Arai Ryota Niikura Yoku Hayakawa Hiroki Sato Takuya Kawahara Tetsuro Honda Kenkei Hasatani Naohiro Yoshida Tsutomu Nishida Tetsuya Sumiyoshi Shu Kiyotoki Takashi Ikeya Masahiro Arai Nobumi Suzuki Yosuke Tsuji Atsuo Yamada Kazuhiko Koike |
| author_facet | Junya Arai Ryota Niikura Yoku Hayakawa Hiroki Sato Takuya Kawahara Tetsuro Honda Kenkei Hasatani Naohiro Yoshida Tsutomu Nishida Tetsuya Sumiyoshi Shu Kiyotoki Takashi Ikeya Masahiro Arai Nobumi Suzuki Yosuke Tsuji Atsuo Yamada Kazuhiko Koike |
| author_sort | Junya Arai |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-16T07:25:21Z |
| format | Article |
| id | doaj.art-e5924cc660304a37a57336d74ddef218 |
| institution | Directory Open Access Journal |
| issn | 2397-9070 |
| language | English |
| last_indexed | 2024-12-16T07:25:21Z |
| publishDate | 2021-07-01 |
| publisher | Wiley |
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| series | JGH Open |
| spelling | doaj.art-e5924cc660304a37a57336d74ddef2182022-12-21T22:39:31ZengWileyJGH Open2397-90702021-07-015777077710.1002/jgh3.12583Nonsteroidal anti‐inflammatory drugs prevent gastric cancer associated with the use of proton pump inhibitors after Helicobacter pylori eradicationJunya Arai0Ryota Niikura1Yoku Hayakawa2Hiroki Sato3Takuya Kawahara4Tetsuro Honda5Kenkei Hasatani6Naohiro Yoshida7Tsutomu Nishida8Tetsuya Sumiyoshi9Shu Kiyotoki10Takashi Ikeya11Masahiro Arai12Nobumi Suzuki13Yosuke Tsuji14Atsuo Yamada15Kazuhiko Koike16Department of Gastroenterology, Graduate School of Medicine The University of Tokyo Bunkyo City Tokyo JapanDepartment of Gastroenterology, Graduate School of Medicine The University of Tokyo Bunkyo City Tokyo JapanDepartment of Gastroenterology, Graduate School of Medicine The University of Tokyo Bunkyo City Tokyo JapanDepartment of Gastroenterology, Graduate School of Medicine The University of Tokyo Bunkyo City Tokyo JapanClinical Research Promotion Center The University of Tokyo Hospital Bunkyo City Tokyo JapanDepartment of Gastroenterology Nagasaki Harbor Medical Center Nagasaki‐shi Nagasaki JapanDepartment of Gastroenterology Fukui Prefectural Hospital Fukui‐shi Fukui JapanDepartment of Gastroenterology Ishikawa Prefectural Central Hospital Kanazawa‐shi Ishikawa JapanDepartment of Gastroenterology Toyonaka Municipal Hospital Toyonaka‐shi Osaka JapanDepartment of Gastroenterology Tonan Hospital Sapporo‐shi Hokkaido JapanDepartment of Gastroenterology Shuto General Hospital Yanai‐shi Yamaguchi JapanDepartment of Gastroenterology St. Luke's International Hospital Chuo‐ku Tokyo JapanDepartment of Gastroenterology Nerima Hikarigaoka Hospital Nerima‐ku Tokyo JapanDepartment of Gastroenterology, Graduate School of Medicine The University of Tokyo Bunkyo City Tokyo JapanDepartment of Gastroenterology, Graduate School of Medicine The University of Tokyo Bunkyo City Tokyo JapanDepartment of Gastroenterology, Graduate School of Medicine The University of Tokyo Bunkyo City Tokyo JapanDepartment of Gastroenterology, Graduate School of Medicine The University of Tokyo Bunkyo City Tokyo JapanAbstract 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.https://doi.org/10.1002/jgh3.12583COX2 inhibitorsgastric cancerHelicobacter pyloriNSAIDsproton pump inhibitor |
| spellingShingle | Junya Arai Ryota Niikura Yoku Hayakawa Hiroki Sato Takuya Kawahara Tetsuro Honda Kenkei Hasatani Naohiro Yoshida Tsutomu Nishida Tetsuya Sumiyoshi Shu Kiyotoki Takashi Ikeya Masahiro Arai Nobumi Suzuki Yosuke Tsuji Atsuo Yamada Kazuhiko Koike Nonsteroidal anti‐inflammatory drugs prevent gastric cancer associated with the use of proton pump inhibitors after Helicobacter pylori eradication JGH Open COX2 inhibitors gastric cancer Helicobacter pylori NSAIDs proton pump inhibitor |
| title | Nonsteroidal anti‐inflammatory drugs prevent gastric cancer associated with the use of proton pump inhibitors after Helicobacter pylori eradication |
| title_full | Nonsteroidal anti‐inflammatory drugs prevent gastric cancer associated with the use of proton pump inhibitors after Helicobacter pylori eradication |
| title_fullStr | Nonsteroidal anti‐inflammatory drugs prevent gastric cancer associated with the use of proton pump inhibitors after Helicobacter pylori eradication |
| title_full_unstemmed | Nonsteroidal anti‐inflammatory drugs prevent gastric cancer associated with the use of proton pump inhibitors after Helicobacter pylori eradication |
| title_short | Nonsteroidal anti‐inflammatory drugs prevent gastric cancer associated with the use of proton pump inhibitors after Helicobacter pylori eradication |
| title_sort | nonsteroidal anti inflammatory drugs prevent gastric cancer associated with the use of proton pump inhibitors after helicobacter pylori eradication |
| topic | COX2 inhibitors gastric cancer Helicobacter pylori NSAIDs proton pump inhibitor |
| url | https://doi.org/10.1002/jgh3.12583 |
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