BACKGROUND: Reducing mucosal cyclo-oxygenase-2 and prostaglandin E(2) production and suppressing intraoesophageal acid may be effective chemopreventive strategies in patients with Barrett's oesophagus. AIM: To compare the effects of aspirin and rofecoxib when administered with esomeprazole on prostaglandin E(2) production, cyclo-oxygenase-2 expression and proliferating cell nuclear antigen expression in patients with Barrett's oesophagus. METHODS: This exploratory, multicentre, randomized, open-label, four-way crossover study in 45 patients with Barrett's oesophagus evaluated prostaglandin E(2) content, proliferating cell nuclear antigen expression, and cyclo-oxygenase-2 expression after 10 days of sequential treatments with: esomeprazole 40 mg twice daily plus aspirin 325 mg once daily (E40 b.d. + A325); E40 b.d. plus rofecoxib 25 mg once daily (E40 b.d. + R25); E40 b.d.; and rofecoxib 25 mg once daily (R25). RESULTS:Prostaglandin E(2) content reduction in Barrett's oesophagus tissue was significantly greater with E40 b.d. + A325 compared with E40 b.d. + R25, E40 b.d. or R25 (P < 0.05). All treatments containing E40 b.d. significantly decreased proliferating cell nuclear antigen expression from baseline (P < 0.05). None of the treatments significantly reduced cyclo-oxygenase-2 expression. CONCLUSIONS: The combined treatment of esomeprazole 40 mg b.d. and aspirin 325 mg significantly decreased mucosal prostaglandin E(2) content and all treatments containing esomeprazole significantly reduced proliferating cell nuclear antigen expression in patients with Barrett's oesophagus.
RCT Entities:
BACKGROUND: Reducing mucosal cyclo-oxygenase-2 and prostaglandin E(2) production and suppressing intraoesophageal acid may be effective chemopreventive strategies in patients with Barrett's oesophagus. AIM: To compare the effects of aspirin and rofecoxib when administered with esomeprazole on prostaglandin E(2) production, cyclo-oxygenase-2 expression and proliferating cell nuclear antigen expression in patients with Barrett's oesophagus. METHODS: This exploratory, multicentre, randomized, open-label, four-way crossover study in 45 patients with Barrett's oesophagus evaluated prostaglandin E(2) content, proliferating cell nuclear antigen expression, and cyclo-oxygenase-2 expression after 10 days of sequential treatments with: esomeprazole 40 mg twice daily plus aspirin 325 mg once daily (E40 b.d. + A325); E40 b.d. plus rofecoxib 25 mg once daily (E40 b.d. + R25); E40 b.d.; and rofecoxib 25 mg once daily (R25). RESULTS:Prostaglandin E(2) content reduction in Barrett's oesophagus tissue was significantly greater with E40 b.d. + A325 compared with E40 b.d. + R25, E40 b.d. or R25 (P < 0.05). All treatments containing E40 b.d. significantly decreased proliferating cell nuclear antigen expression from baseline (P < 0.05). None of the treatments significantly reduced cyclo-oxygenase-2 expression. CONCLUSIONS: The combined treatment of esomeprazole 40 mg b.d. and aspirin 325 mg significantly decreased mucosal prostaglandin E(2) content and all treatments containing esomeprazole significantly reduced proliferating cell nuclear antigen expression in patients with Barrett's oesophagus.
Authors: David E Fleischer; Robert Odze; Bergein F Overholt; John Carroll; Kenneth J Chang; Ananya Das; John Goldblum; Daniel Miller; Charles J Lightdale; Jeffrey Peters; Richard Rothstein; Virender K Sharma; Daniel Smith; Victor Velanovich; Herbert Wolfsen; George Triadafilopoulos Journal: Dig Dis Sci Date: 2010-04-20 Impact factor: 3.199
Authors: Paula Esquivias; Antonio Morandeira; Alfredo Escartín; Carmelo Cebrián; Sonia Santander; Francisco Esteva; María Asunción García-González; Javier Ortego; Angel Lanas; Elena Piazuelo Journal: World J Gastroenterol Date: 2012-09-21 Impact factor: 5.742
Authors: Gary W Falk; Navtej S Buttar; Nathan R Foster; Katie L Allen Ziegler; Catherine J Demars; Yvonne Romero; Norman E Marcon; Thomas Schnell; Douglas A Corley; Prateek Sharma; Marcia R Cruz-Correa; Chin Hur; David E Fleischer; Amitabh Chak; Kenneth R Devault; David S Weinberg; Gary Della'Zanna; Ellen Richmond; Thomas C Smyrk; Sumithra J Mandrekar; Paul J Limburg Journal: Gastroenterology Date: 2012-07-11 Impact factor: 22.682