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Article: Effects of selective COX-2 inhibitor and Helicobacter pylori eradication on precancerous gastric lesions
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TitleEffects of selective COX-2 inhibitor and Helicobacter pylori eradication on precancerous gastric lesions
 
AuthorsWong, 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 Date2012
 
PublisherBMJ Publishing Group. The Journal's web site is located at http://gut.bmjjournals.com/
 
CitationGut, 2012, v. 61 n. 6, p. 812-818 [How to Cite?]
DOI: http://dx.doi.org/10.1136/gutjnl-2011-300154
 
AbstractObjective: 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.
 
ISSN0017-5749
2013 Impact Factor: 13.319
 
DOIhttp://dx.doi.org/10.1136/gutjnl-2011-300154
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorWong, BCY
 
dc.contributor.authorZhang, L
 
dc.contributor.authorMa, JL
 
dc.contributor.authorPan, KF
 
dc.contributor.authorLi, JY
 
dc.contributor.authorShen, L
 
dc.contributor.authorLiu, WD
 
dc.contributor.authorFeng, GS
 
dc.contributor.authorZhang, XD
 
dc.contributor.authorLi, J
 
dc.contributor.authorLu, AP
 
dc.contributor.authorXia, HHX
 
dc.contributor.authorLam, S
 
dc.contributor.authorYou, WC
 
dc.date.accessioned2012-09-05T05:31:53Z
 
dc.date.available2012-09-05T05:31:53Z
 
dc.date.issued2012
 
dc.description.abstractObjective: 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.naturelink_to_subscribed_fulltext
 
dc.identifier.citationGut, 2012, v. 61 n. 6, p. 812-818 [How to Cite?]
DOI: http://dx.doi.org/10.1136/gutjnl-2011-300154
 
dc.identifier.doihttp://dx.doi.org/10.1136/gutjnl-2011-300154
 
dc.identifier.epage818
 
dc.identifier.issn0017-5749
2013 Impact Factor: 13.319
 
dc.identifier.issue6
 
dc.identifier.pmid21917649
 
dc.identifier.scopuseid_2-s2.0-84860573640
 
dc.identifier.spage812
 
dc.identifier.urihttp://hdl.handle.net/10722/163485
 
dc.identifier.volume61
 
dc.languageeng
 
dc.publisherBMJ Publishing Group. The Journal's web site is located at http://gut.bmjjournals.com/
 
dc.publisher.placeUnited Kingdom
 
dc.relation.ispartofGut
 
dc.relation.referencesReferences in Scopus
 
dc.titleEffects of selective COX-2 inhibitor and Helicobacter pylori eradication on precancerous gastric lesions
 
dc.typeArticle
 
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<contributor.author>Pan, KF</contributor.author>
<contributor.author>Li, JY</contributor.author>
<contributor.author>Shen, L</contributor.author>
<contributor.author>Liu, WD</contributor.author>
<contributor.author>Feng, GS</contributor.author>
<contributor.author>Zhang, XD</contributor.author>
<contributor.author>Li, J</contributor.author>
<contributor.author>Lu, AP</contributor.author>
<contributor.author>Xia, HHX</contributor.author>
<contributor.author>Lam, S</contributor.author>
<contributor.author>You, WC</contributor.author>
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Author Affiliations
  1. Healthy Bureau of Linqu County
  2. The University of Hong Kong
  3. Beijing Cancer Hospital