David J. Bjorkman, MD, MSPH (HSA), SM (Epid.) reviewing Thrift AP et al. Am J Gastroenterol 2016 Aug 30.

The lower risk for adenocarcinoma previously seen with NSAID use may result from an effect on esophageal tissue that has already undergone metaplastic change.

Studies have suggested that regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) lowers risk for adenocarcinoma of the esophagus. Does it also lower risk for Barrett esophagus (BE), a precursor of esophageal adenocarcinoma?

To find out, investigators pooled the results of six population-based, case-control trials that included data on NSAID use in 1474 patients with BE, 2018 patients with gastroesophageal reflux disease (GERD), and 2256 population controls. Among the study population, 47.0% used any NSAID regularly (at least weekly), 31.7% used aspirin regularly, and 19.6% used non-aspirin NSAIDs regularly.

Multivariable analysis that controlled for potential confounding factors found no difference in NSAID use among the groups. Separating aspirin from other NSAIDs showed similar results, as did evaluating the frequency and duration of drug use.

CITATION(S):

Thrift AP et al. Nonsteroidal anti-inflammatory drug use is not associated with reduced risk of Barrett's esophagus. Am J Gastroenterol 2016 Aug 30; [e-pub].

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