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

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 randomi... Full description

Journal Title: Gut 2012, Vol.61 (6), p.812-818
Main Author: Wong, Benjamin C Y
Other Authors: 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
Format: Electronic Article Electronic Article
Language: English
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Publisher: London: BMJ Publishing Group Ltd and British Society of Gastroenterology
ID: ISSN: 0017-5749
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title: Effects of selective COX-2 inhibitor and Helicobacter pylori eradication on precancerous gastric lesions
format: Article
creator:
  • 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
subjects:
  • Adult
  • Amoxicillin - administration & dosage
  • Amoxicillin - therapeutic use
  • Anti-Bacterial Agents - administration & dosage
  • Anti-Bacterial Agents - therapeutic use
  • Antibiotics
  • Bacterial diseases
  • Bacterial diseases of the digestive system and abdomen
  • Biological and medical sciences
  • Biopsy
  • Bones, joints and connective tissue. Antiinflammatory agents
  • Celecoxib
  • cell proliferation
  • Clarithromycin - administration & dosage
  • Clarithromycin - therapeutic use
  • clinical trials
  • COX-2 inhibitor
  • COX-2 inhibitors
  • Cyclooxygenase 2 Inhibitors - therapeutic use
  • Dosage and administration
  • Double-Blind Method
  • Drug therapy
  • Drug Therapy, Combination
  • Endoscopy
  • epidemiology
  • Female
  • functional dyspepsia
  • Gastric cancer
  • Gastroenterology. Liver. Pancreas. Abdomen
  • Helicobacter infections
  • Helicobacter Infections - complications
  • Helicobacter Infections - drug therapy
  • Helicobacter pylori
  • Human bacterial diseases
  • Humans
  • Infectious diseases
  • intervention trial
  • Male
  • Medical sciences
  • Middle Aged
  • Omeprazole - administration & dosage
  • Omeprazole - therapeutic use
  • Pathology
  • Pharmacology. Drug treatments
  • Population
  • Precancerous conditions
  • Precancerous Conditions - etiology
  • Precancerous Conditions - pathology
  • Precancerous Conditions - prevention & control
  • precancerous lesions
  • Pyrazoles - therapeutic use
  • Quality
  • Stomach - pathology
  • Stomach cancer
  • Stomach Neoplasms - etiology
  • Stomach Neoplasms - pathology
  • Stomach Neoplasms - prevention & control
  • Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
  • Studies
  • Sulfonamides - therapeutic use
  • Tumors
ispartof: Gut, 2012, Vol.61 (6), p.812-818
description: 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.
language: eng
source:
identifier: ISSN: 0017-5749
fulltext: no_fulltext
issn:
  • 0017-5749
  • 1468-3288
url: Link


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titleEffects of selective COX-2 inhibitor and Helicobacter pylori eradication on precancerous gastric lesions
creatorWong, 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
creatorcontribWong, 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
descriptionObjectiveHelicobacter 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.
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1Zhang, Lian
2Ma, Jun-ling
3Pan, Kai-feng
4Li, Ji-you
5Shen, Lin
6Liu, Wei-dong
7Feng, Guo-shuang
8Zhang, Xiao-dong
9Li, Jie
10Lu, Ai-ping
11Xia, Harry H X
12Lam, Shiukum
13You, Wei-cheng
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0Effects of selective COX-2 inhibitor and Helicobacter pylori eradication on precancerous gastric lesions
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descriptionObjectiveHelicobacter 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.
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1Amoxicillin - administration & dosage
2Amoxicillin - therapeutic use
3Anti-Bacterial Agents - administration & dosage
4Anti-Bacterial Agents - therapeutic use
5Antibiotics
6Bacterial diseases
7Bacterial diseases of the digestive system and abdomen
8Biological and medical sciences
9Biopsy
10Bones, joints and connective tissue. Antiinflammatory agents
11Celecoxib
12cell proliferation
13Clarithromycin - administration & dosage
14Clarithromycin - therapeutic use
15clinical trials
16COX-2 inhibitor
17COX-2 inhibitors
18Cyclooxygenase 2 Inhibitors - therapeutic use
19Dosage and administration
20Double-Blind Method
21Drug therapy
22Drug Therapy, Combination
23Endoscopy
24epidemiology
25Female
26functional dyspepsia
27Gastric cancer
28Gastroenterology. Liver. Pancreas. Abdomen
29Helicobacter infections
30Helicobacter Infections - complications
31Helicobacter Infections - drug therapy
32Helicobacter pylori
33Human bacterial diseases
34Humans
35Infectious diseases
36intervention trial
37Male
38Medical sciences
39Middle Aged
40Omeprazole - administration & dosage
41Omeprazole - therapeutic use
42Pathology
43Pharmacology. Drug treatments
44Population
45Precancerous conditions
46Precancerous Conditions - etiology
47Precancerous Conditions - pathology
48Precancerous Conditions - prevention & control
49precancerous lesions
50Pyrazoles - therapeutic use
51Quality
52Stomach - pathology
53Stomach cancer
54Stomach Neoplasms - etiology
55Stomach Neoplasms - pathology
56Stomach Neoplasms - prevention & control
57Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
58Studies
59Sulfonamides - therapeutic use
60Tumors
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3Pan, Kai-feng
4Li, Ji-you
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6Liu, Wei-dong
7Feng, Guo-shuang
8Zhang, Xiao-dong
9Li, Jie
10Lu, Ai-ping
11Xia, Harry H X
12Lam, Shiukum
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titleEffects of selective COX-2 inhibitor and Helicobacter pylori eradication on precancerous gastric lesions
authorWong, 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
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1Amoxicillin - administration & dosage
2Amoxicillin - therapeutic use
3Anti-Bacterial Agents - administration & dosage
4Anti-Bacterial Agents - therapeutic use
5Antibiotics
6Bacterial diseases
7Bacterial diseases of the digestive system and abdomen
8Biological and medical sciences
9Biopsy
10Bones, joints and connective tissue. Antiinflammatory agents
11Celecoxib
12cell proliferation
13Clarithromycin - administration & dosage
14Clarithromycin - therapeutic use
15clinical trials
16COX-2 inhibitor
17COX-2 inhibitors
18Cyclooxygenase 2 Inhibitors - therapeutic use
19Dosage and administration
20Double-Blind Method
21Drug therapy
22Drug Therapy, Combination
23Endoscopy
24epidemiology
25Female
26functional dyspepsia
27Gastric cancer
28Gastroenterology. Liver. Pancreas. Abdomen
29Helicobacter infections
30Helicobacter Infections - complications
31Helicobacter Infections - drug therapy
32Helicobacter pylori
33Human bacterial diseases
34Humans
35Infectious diseases
36intervention trial
37Male
38Medical sciences
39Middle Aged
40Omeprazole - administration & dosage
41Omeprazole - therapeutic use
42Pathology
43Pharmacology. Drug treatments
44Population
45Precancerous conditions
46Precancerous Conditions - etiology
47Precancerous Conditions - pathology
48Precancerous Conditions - prevention & control
49precancerous lesions
50Pyrazoles - therapeutic use
51Quality
52Stomach - pathology
53Stomach cancer
54Stomach Neoplasms - etiology
55Stomach Neoplasms - pathology
56Stomach Neoplasms - prevention & control
57Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
58Studies
59Sulfonamides - therapeutic use
60Tumors
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1Zhang, Lian
2Ma, Jun-ling
3Pan, Kai-feng
4Li, Ji-you
5Shen, Lin
6Liu, Wei-dong
7Feng, Guo-shuang
8Zhang, Xiao-dong
9Li, Jie
10Lu, Ai-ping
11Xia, Harry H X
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8Zhang, Xiao-dong
9Li, Jie
10Lu, Ai-ping
11Xia, Harry H X
12Lam, Shiukum
13You, Wei-cheng
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abstractObjectiveHelicobacter 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.
copLondon
pubBMJ Publishing Group Ltd and British Society of Gastroenterology
pmid21917649
doi10.1136/gutjnl-2011-300154