Nonsteroidal anti-inflammatory drug use is not associated with reduced risk of Barrett's Esophagus

Aaron P. Thrift*, Lesley A. Anderson, Liam J. Murray, Michael B. Cook, Nicholas J. Shaheen, Joel H. Rubenstein, Hashem B. El-Serag, Thomas L. Vaughan, Jennifer L. Schneider, David C. Whiteman, Douglas A. Corley

*Corresponding author for this work

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

 Objectives: Regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with a reduced risk of esophageal adenocarcinoma. Epidemiological studies examining the association between NSAID use and the risk of the precursor lesion, Barrett's esophagus, have been inconclusive.

 Methods: We analyzed pooled individual-level participant data from six case-control studies of Barrett's esophagus in the Barrett's and Esophageal Adenocarcinoma Consortium (BEACON). We compared medication use from 1,474 patients with Barrett's esophagus separately with two control groups: 2,256 population-based controls and 2,018 gastroesophageal reflux disease (GERD) controls. Study-specific odds ratio (OR) and 95% confidence intervals (CI) were estimated using multivariable logistic regression models and were combined using a random-effects meta-analytic model.

 Results: Regular (at least once weekly) use of any NSAIDs was not associated with the risk of Barrett's esophagus (vs. population-based controls, adjusted OR=1.00, 95% CI=0.76-1.32, I 2 =61%; vs. GERD controls, adjusted OR=0.99, 95% CI=0.82-1.19, I 2 =19%). Similar null findings were observed among individuals who took aspirin or non-aspirin NSAIDs. We also found no association with highest levels of frequency (at least daily use) and duration (≥5 years) of NSAID use. There was evidence of moderate between-study heterogeneity; however, associations with NSAID use remained non-significant in "leave-one-out" sensitivity analyses.

 Conclusions: Use of NSAIDs was not associated with the risk of Barrett's esophagus. The previously reported inverse association between NSAID use and esophageal adenocarcinoma may be through reducing the risk of neoplastic progression in patients with Barrett's esophagus.

Original languageEnglish
Pages (from-to)1528-1535
Number of pages8
JournalAmerican journal of gastroenterology
Volume111
Issue number11
Early online date30 Aug 2016
DOIs
Publication statusPublished - 1 Nov 2016

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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    Thrift, A. P., Anderson, L. A., Murray, L. J., Cook, M. B., Shaheen, N. J., Rubenstein, J. H., El-Serag, H. B., Vaughan, T. L., Schneider, J. L., Whiteman, D. C., & Corley, D. A. (2016). Nonsteroidal anti-inflammatory drug use is not associated with reduced risk of Barrett's Esophagus. American journal of gastroenterology, 111(11), 1528-1535. https://doi.org/10.1038/ajg.2016.348