Details

Autor(en) / Beteiligte

• Wong, Benjamin C Y
• Zhang, Lian
• Ma, Jun-ling
• Pan, Kai-feng
• Li, Ji-you
• Shen, Lin
• Liu, Wei-dong
• Feng, Guo-shuang
• Zhang, Xiao-dong
• Li, Jie
• Lu, Ai-ping
• Xia, Harry H X
• Lam, Shiukum
• You, Wei-cheng

Titel

Effects of selective COX-2 inhibitor and Helicobacter pylori eradication on precancerous gastric lesions

Ist Teil von

• Gut, 2012-06, Vol.61 (6), p.812-818

Ort / Verlag

London: BMJ Publishing Group Ltd and British Society of Gastroenterology

Erscheinungsjahr

2012

Quelle

BMJ Journals Archiv - DFG Nationallizenzen

Beschreibungen/Notizen

• ObjectiveHelicobacter 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, placebo-controlled trial was conducted in Linqu County, Shandong Province, China.MethodsA 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.ResultsOf 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 per-protocol 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).ConclusionThis 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 registrationHARECCTR0500053 in accordance with WHO ICTRP requirements.