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Aspirin may be protective against Barrett's esophagus
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Patients taking aspirin may be at a reduced risk for developing Barrett’s esophagus, according to results from a recent case-controlled study.
Researchers compared 434 patients with Barrett’s esophagus (BE) diagnosed via endoscopy against controls matched according to indication and year of endoscopy and the performing endoscopist. Evaluated potential risk factors for the condition included age, sex, BMI, and medical and social history.
Multivariate analysis indicated an inverse association between BE risk and aspirin use (adjusted OR=0.56; 95% CI, 0.39-0.80), as well as an association between BE and male sex (adjusted OR=3.2; 95% CI, 2.3-4.4). The protective effect of aspirin was found to be dose-dependent, with a daily dose of 325 mg or more significantly associated with decreased BE risk (OR=0.36; 95% CI, 0.20-0.64), while a lower dose was not (OR=0.92; 95% CI, 0.57-1.4). Investigators also further stratified for use of acid suppressants, and found that the reduced risk for BE remained among users of both aspirin and acid suppressants (OR=0.59; 95% CI, 0.36-0.99) and those on aspirin alone (OR=0.58; 95% CI, 0.30-1.1), though the latter was not found statistically significant.
In a subgroup analysis of patients who underwent endoscopy because of GERD symptoms, the inverse association between aspirin and BE risk remained (n=189 patients and 189 controls, adjusted OR=0.49; 95% CI, 0.33-1.0), as did the association with male sex (adjusted OR=3.0; 95% CI, 1.9-4.7). The dose-dependent relationship also was upheld in this cohort (OR=0.30; 95% CI, 0.12-0.72 for a dose of 325 mg/day or more).
“Although numerous studies have demonstrated an association between aspirin use and decreased risk of [esophageal adenocarcinoma], our study is the largest US study to find a diminished risk of BE in aspirin users,” the researchers wrote. “Further studies should be directed toward examining the dose-duration relationship between aspirin use and risk of BE and compare the robustness of our findings by using population controls.”
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