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
2011 Impact Factor: 10.111
2011 SCImago Journal Rankings: 0.883
DOIhttp://dx.doi.org/10.1136/gutjnl-2011-300154
ReferencesReferences in Scopus
DC Field
Value
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
2011 Impact Factor: 10.111
2011 SCImago Journal Rankings: 0.883
dc.identifier.issue6
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
Author Affiliations
  1. Healthy Bureau of Linqu County
  2. The University of Hong Kong
  3. Beijing Cancer Hospital