Do proton pump inhibitors prevent Barrett’s esophagus progression to high-grade dysplasia and esophageal adenocarcinoma? An updated meta-analysis

Chen, Yue; Sun, Chenyu; Wu, Yun; Chen, Xin; Kailas, Sujatha; Karadsheh, Zeid; Li, Guangyuan; Guo, Zhichun; Yang, Hongxia; Hu, Lei; Zhou, Qin

doi:10.1007/s00432-021-03544-3

Cited by 23 publications

(22 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…ПБ -это предраковое состояние, обусловливающее повышенный риск развития аденокарциномы пищевода путем последовательного перехода от метапластического эпителия без дисплазии к дисплазии низкой и высокой степени и в конечном итоге к раку [1,4]. На сегодняшний день доказано, что постоянная терапия с применением ИПП способствует редукции кумулятивного риска развития неопластических изменений у пациентов с ПБ [3,[14][15][16]. Вместе с тем в рутинной клинической практике нередко бывают ситуации, требующие временной (от 1 нед до около месяца) отмены ИПП для валидного проведения ряда диагностических мероприятий, и ряд других причин [17,24].…”

Section: Discussionunclassified

“…(2021 г. ), обобщивший результаты 12 исследований (n=155 769), продемонстрировал, что применение ИПП ассоциировано со значительным снижением риска прогрессирования ПБ до дисплазии высокой степени/аденокарциномы пищевода (ОШ 0,47, 95% ДИ 0,32-0,71) [16].…”

Section: Introductionunclassified

See 1 more Smart Citation

Efficacy of esophagoprotection with short periods of withdrawal of maintenance therapy with proton pump inhibitors in patients with Barrett's esophagus

Kucheryavy¹,

Movtaeva²,

Zayratyants³

et al. 2021

View full text Add to dashboard Cite

Aim. Evaluation of the effectiveness of esophagoprotection in covering up short periods of withdrawal of maintenance therapy with proton pump inhibitors (PPIs) in patients with Barrett's esophagus (BE). Materials and methods. A retrospective analysis of the data of patients with histologically verified BE who received outpatient PPI therapy for at least 12 months was carried out. This cohort was divided into two groups to compare depending on the treatment regimen received. The first group included only patients who take PPIs constantly, while the second group included patients who had periodic interruptions in taking PPIs. In the second group, we analyzed only cases where to cover up the periods of PPI withdrawal the patients used the esophagoprotector Alfasoxx (10 ml 4 times a day, after each meal and at night). In the cohort, demographic data (age, gender), risk factors, length of the BE segment, degree of dysplasia, number of relapses of erosive esophagitis, and the data of high-resolution manometry on movement disorders of the thoracic esophagus (ineffective motility and lack of contractility) were analyzed. Results. The study included 39 patients (28 men and 11 women) with histologically verified BE. The average age was 57,1538 years (95% confidence interval 53.4269–60.8808). The gender structure was dominated by men (n=28). The duration of BE history in the analyzed cohort was 5.6769 years (95% confidence interval, 4.6161–6.7378). The first group consisted of 23 patients who take PPIs constantly. The second group consisted of 16 patients who had periodic interruptions in taking PPIs, which were covered by the esophagoprotector Alfasoxx. In the analyzed cohort, there were no significant differences between the groups in the average length of the BE segment, the number of patients with a long BE segment, the degree of dysplasia, the number of relapses of erosive esophagitis, and the rate of movement disorders of the thoracic esophagus. Conclusion. In routine practice, there are reasons for the temporary withdrawal of PPIs in patients with BE, which requires the administration of course esophagoprotection to cover up the risks. The results of this retrospective comparative study demonstrate the effectiveness of this strategy.

show abstract

Section: Discussionunclassified

Section: Introductionunclassified

Efficacy of esophagoprotection with short periods of withdrawal of maintenance therapy with proton pump inhibitors in patients with Barrett's esophagus

Kucheryavy¹,

Movtaeva²,

Zayratyants³

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Specifically, the annual incidence of EAC has been reported to be 0.3–0.6%, and annual combined incidence of HGD and EAC to be 0.9–1.0% [ 42 ]. In addition to endoscopic surveillance, it is recommended that patients start a low-dose proton pump inhibitor (PPI), as this has been associated with decreased risk of HGD and EAC [ 43 ].…”

Section: Management Of Barrett’s Esophagusmentioning

confidence: 99%

Endoscopic Management of Esophageal Cancer

Paiji

Sedarat

2022

Cancers

View full text Add to dashboard Cite

Advances in technology and improved understanding of the pathobiology of esophageal cancer have allowed endoscopy to serve a growing role in the management of this disease. Precursor lesions can be detected using enhanced diagnostic modalities and eradicated with ablation therapy. Furthermore, evolution in endoscopic resection has provided larger specimens for improved diagnostic accuracy and offer potential for cure of early esophageal cancer. In patients with advanced esophageal cancer, endoluminal therapy can improve symptom burden and provide therapeutic options for complications such as leaks, perforations, and fistulas. The purpose of this review article is to highlight the role of endoscopy in the diagnosis, treatment, and palliation of esophageal cancer.

show abstract

“…However, most epidemiologic studies conducted in Western countries and several meta-analyses have denied the carcinogenic effect of PPI or H2RA use on developing esophageal cancer [ 7 , 19 , 21 , 22 , 23 , 24 , 25 ]. Rather, they claimed the preventive effect of PPI or H2RA against esophageal cancers [ 7 , 19 , 21 , 22 , 23 , 26 , 27 ], with up to 71% lower risk of neoplastic progression [ 23 ]. In vitro study has shown significant antitumor effects of PPI in diminishing invasiveness and promoting apoptosis in esophageal cancer cells [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

Possible Association between the Use of Proton Pump Inhibitors and H2 Receptor Antagonists, and Esophageal Cancer: A Nested Case–Control Study Using a Korean National Health Screening Cohort

et al. 2022

View full text Add to dashboard Cite

Although safety concerns regarding proton pump inhibitor (PPI)/H2-receptor antagonists (H2RA) in the incident esophageal cancer have been raised, the Asian-based report is unclear. We investigated the estimated likelihood of incident esophageal cancer—its mortality depending on prior history of PPI/H2RA use—and gastroesophageal reflux disease (GERD) in Koreans. Using the Korean National Health Insurance Service-Health Screening Cohort data (2002–2015), a case–control study was retrospectively conducted, including 811 patients with incident esophageal cancer and 3244 controls matched with sex, age, income, and residence. Propensity score overlap weighting was adjusted to balance the baseline covariates. Overlap propensity score-weighted logistic regression analyses were assessed to determine associations of the prior exposure of PPI/H2RA (current vs. past) and the medication duration (<30-, 30–90-, vs. ≥90-days) with incident esophageal cancer and its mortality among the total participants or those with/without the GERD episodes, after adjusting for multiple covariates including PPI/H2RA. The current exposure to either PPI or H2RA showed higher odds for incident esophageal cancer than the nonuser group ([13.23; 95%CI 10.25–17.06] and [4.34; 95%CI 3.67–5.14], respectively), especially in all adults over the age of 40 years without GERD. Both current and past exposures to PPI showed a decreased probability of mortality compared with those of the nonuser group ([0.62; 95%CI 0.45–0.86] and [0.41; 95%CI 0.25–0.67], respectively). However, current or past exposure to H2RA harbored the mutually different likelihoods for mortality depending on the presence of GERD and old age. This study carefully speculates on the possible link between PPI/H2RA and incident esophageal cancer in the Korean population. Mortality appears to be affected by certain risk factors depending on drug types, exposure history, old age, and the presence of GERD.

show abstract

Do proton pump inhibitors prevent Barrett’s esophagus progression to high-grade dysplasia and esophageal adenocarcinoma? An updated meta-analysis

Cited by 23 publications

References 54 publications

Efficacy of esophagoprotection with short periods of withdrawal of maintenance therapy with proton pump inhibitors in patients with Barrett's esophagus

Efficacy of esophagoprotection with short periods of withdrawal of maintenance therapy with proton pump inhibitors in patients with Barrett's esophagus

Endoscopic Management of Esophageal Cancer

Possible Association between the Use of Proton Pump Inhibitors and H2 Receptor Antagonists, and Esophageal Cancer: A Nested Case–Control Study Using a Korean National Health Screening Cohort

Contact Info

Product

Resources

About