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The effects of esomeprazole combined with aspirin or rofecoxib on prostaglandin E 2 production in patients with Barrett's oesophagus
Author(s) -
TRIADAFILOPOULOS G.,
KAUR B.,
SOOD S.,
TRAXLER B.,
LEVINE D.,
WESTON A.
Publication year - 2006
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2006.02847.x
Subject(s) - rofecoxib , medicine , esomeprazole , aspirin , prostaglandin e2 , cyclooxygenase , prostaglandin , gastroenterology , pharmacology , crossover study , chemistry , biochemistry , pathology , placebo , enzyme , alternative medicine
Summary 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.