Article: Effects of selective COX-2 inhibitor and Helicobacter pylori eradication on precancerous gastric lesions
| Title | Effects of selective COX-2 inhibitor and Helicobacter pylori eradication on precancerous gastric lesions |
|---|---|
| Authors | Wong, BCY2 Zhang, L3 Ma, JL3 Pan, KF3 Li, JY3 Shen, L3 Liu, WD1 Feng, GS3 Zhang, XD3 Li, J3 Lu, AP3 Xia, HHX2 Lam, S2 You, WC3 |
| Issue Date | 2012 |
| Publisher | BMJ Publishing Group. The Journal's web site is located at http://gut.bmjjournals.com/ |
| Citation | Gut, 2012, v. 61 n. 6, p. 812-818 [How to Cite?] DOI: http://dx.doi.org/10.1136/gutjnl-2011-300154 |
| Abstract | Objective: Helicobacter pylori infection and overexpression of cyclo-oxygenase-2 (COX-2) are associated with gastric cancer and its precursors. To evaluate the effect of a selective COX-2 inhibitor alone and combined with H pylori eradication on the evolution of precancerous gastric lesions, a randomised, placebocontrolled trial was conducted in Linqu County, Shandong Province, China. Methods: A total of 1024 participants aged 35-64 years with H pylori infection and advanced gastric lesions were randomly assigned in a factorial design to two interventions or placebo: anti-H pylori treatment for 7 days, and a COX-2 inhibitor (celecoxib) for 24 months. The effects of the interventions were evaluated by the regression or progression of advanced gastric lesions. Results: Of the 1024 participants who received anti-H pylori treatment or placebo, 919 completed a subsequent 24-month treatment with celecoxib or placebo. The H pylori eradication rate by per-protocol analysis was 78.2%. Compared with placebo, the proportions of regression of gastric lesions significantly increased in the celecoxib treatment (52.8% vs 41.2%) and anti-H pylori treatment (59.3% vs 41.2%) group, and OR by perprotocol analysis was 1.72 (95% CI 1.07 to 2.76) for celecoxib and 2.19 (95% CI 1.32 to 3.64) for H pylori eradication. No statistically significant effect was found for H pylori eradication followed by celecoxib on the regression of advanced gastric lesions (OR 1.48, 95% CI 0.91 to 2.40). Conclusion: This population-based intervention trial revealed that celecoxib treatment or H pylori eradication alone had beneficial effects on the regression of advanced gastric lesions. No favourable effects were seen for H pylori eradication followed by celecoxib treatment. Trial registration: HARECCTR0500053 in accordance with WHO ICTRP requirements. |
| ISSN | 0017-5749 2011 Impact Factor: 10.111 2011 SCImago Journal Rankings: 0.883 |
| DOI | http://dx.doi.org/10.1136/gutjnl-2011-300154 |
| References | References in Scopus |
| dc.contributor.author | Wong, BCY |
|---|---|
| dc.contributor.author | Zhang, L |
| dc.contributor.author | Ma, JL |
| dc.contributor.author | Pan, KF |
| dc.contributor.author | Li, JY |
| dc.contributor.author | Shen, L |
| dc.contributor.author | Liu, WD |
| dc.contributor.author | Feng, GS |
| dc.contributor.author | Zhang, XD |
| dc.contributor.author | Li, J |
| dc.contributor.author | Lu, AP |
| dc.contributor.author | Xia, HHX |
| dc.contributor.author | Lam, S |
| dc.contributor.author | You, WC |
| dc.date.accessioned | 2012-09-05T05:31:53Z |
| dc.date.available | 2012-09-05T05:31:53Z |
| dc.date.issued | 2012 |
| dc.description.abstract | Objective: Helicobacter pylori infection and overexpression of cyclo-oxygenase-2 (COX-2) are associated with gastric cancer and its precursors. To evaluate the effect of a selective COX-2 inhibitor alone and combined with H pylori eradication on the evolution of precancerous gastric lesions, a randomised, placebocontrolled trial was conducted in Linqu County, Shandong Province, China. Methods: A total of 1024 participants aged 35-64 years with H pylori infection and advanced gastric lesions were randomly assigned in a factorial design to two interventions or placebo: anti-H pylori treatment for 7 days, and a COX-2 inhibitor (celecoxib) for 24 months. The effects of the interventions were evaluated by the regression or progression of advanced gastric lesions. Results: Of the 1024 participants who received anti-H pylori treatment or placebo, 919 completed a subsequent 24-month treatment with celecoxib or placebo. The H pylori eradication rate by per-protocol analysis was 78.2%. Compared with placebo, the proportions of regression of gastric lesions significantly increased in the celecoxib treatment (52.8% vs 41.2%) and anti-H pylori treatment (59.3% vs 41.2%) group, and OR by perprotocol analysis was 1.72 (95% CI 1.07 to 2.76) for celecoxib and 2.19 (95% CI 1.32 to 3.64) for H pylori eradication. No statistically significant effect was found for H pylori eradication followed by celecoxib on the regression of advanced gastric lesions (OR 1.48, 95% CI 0.91 to 2.40). Conclusion: This population-based intervention trial revealed that celecoxib treatment or H pylori eradication alone had beneficial effects on the regression of advanced gastric lesions. No favourable effects were seen for H pylori eradication followed by celecoxib treatment. Trial registration: HARECCTR0500053 in accordance with WHO ICTRP requirements. |
| dc.description.nature | Link_to_subscribed_fulltext |
| dc.identifier.citation | Gut, 2012, v. 61 n. 6, p. 812-818 [How to Cite?] DOI: http://dx.doi.org/10.1136/gutjnl-2011-300154 |
| dc.identifier.doi | http://dx.doi.org/10.1136/gutjnl-2011-300154 |
| dc.identifier.epage | 818 |
| dc.identifier.issn | 0017-5749 2011 Impact Factor: 10.111 2011 SCImago Journal Rankings: 0.883 |
| dc.identifier.issue | 6 |
| dc.identifier.scopus | eid_2-s2.0-84860573640 |
| dc.identifier.spage | 812 |
| dc.identifier.uri | http://hdl.handle.net/10722/163485 |
| dc.identifier.volume | 61 |
| dc.language | eng |
| dc.publisher | BMJ Publishing Group. The Journal's web site is located at http://gut.bmjjournals.com/ |
| dc.publisher.place | United Kingdom |
| dc.relation.ispartof | Gut |
| dc.relation.references | References in Scopus |
| dc.title | Effects of selective COX-2 inhibitor and Helicobacter pylori eradication on precancerous gastric lesions |
| dc.type | Article |
Author Affiliations
- Healthy Bureau of Linqu County
- The University of Hong Kong
- Beijing Cancer Hospital

