Aspirin may reduce risk for Barrett’s esophagus

Issue: August 25, 2012

Patients who take aspirin may be at a reduced risk for developing Barrett’s esophagus, according to results of a case-control study.

Researchers compared 434 patients with Barrett’s esophagus diagnosed via endoscopy with 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 Barrett’s esophagus risk and aspirin use (adjusted OR=0.56; 95% CI, 0.39-0.80), as well as an association between Barrett’s esophagus and male sex (adjusted OR=3.2; 95% CI, 2.3-4.4).

The protective effect of aspirin was found to be dose-dependent. A daily dose of 325 mg or more was significantly associated with decreased risk (OR=0.36; 95% CI, 0.20-0.64), whereas a lower dose was not (OR=0.92; 95% CI, 0.57-1.4). Investigators stratified the data for use of acid suppressants, and they found that the reduced risk for Barrett’s esophagus 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).

In a subgroup analysis of patients who underwent endoscopy because of gastroesophageal reflux disease symptoms, the inverse association between aspirin and Barrett’s esophagus 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 Barrett’s esophagus in aspirin users,” the researchers wrote. “Further studies should be directed toward examining the dose-duration relationship between aspirin use and risk of Barrett’s esophagus and compare the robustness of our findings by using population controls.”

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Source:

Omer ZB. Clin Gastroenterol Hepatol. 2012;10;722-727.