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Short‐term celecoxib to regress long‐term persistent gastric intestinal metaplasia after Helicobacter pylori eradication
Author(s) -
Hung KueiHsiang,
Yang HsiaoBai,
Cheng HsiuChi,
Wu JiunnJong,
Sheu BorShyang
Publication year - 2010
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2009.05974.x
Subject(s) - celecoxib , medicine , gastroenterology , creatinine , intestinal metaplasia , proportional hazards model , cyclooxygenase , helicobacter pylori , cox 2 inhibitor , enzyme , biochemistry , chemistry
Background and Aim: The intestinal metaplasia (IM) has overexpressions of cyclooxygenase‐2 (COX‐2) and β‐catenin. This pilot study assessed whether celecoxib, a selective COX‐2 inhibitor, could regress IM that persisted long term after Helicobacter pylori eradication. Methods: Thirty‐three patients with H. pylori eradication were enrolled in the present study due to the persistence of IM after a 3‐year follow up. These patients received celecoxib 200 mg/day for 8 weeks, and were serially checked for levels of blood urea nitrogen and creatinine once per 2 weeks. After 8‐week celecoxib treatment, IM regression was assessed by panendoscopy. The gastric specimens, taken before and after celecoxib, were immunochemically stained for COX‐2 and β‐catenin. Results: The intention‐to‐treat and per‐protocol analyses to the rates of IM regression by 8‐week celecoxib treatment were 24.2% (8/33) and 28.6% (8/28), respectively. All enrolled patients had no renal impairment. Even in the patients without total IM regression, mean IM scores in the antrum decreased after 8‐week celecoxib treatment ( P = 0.007). The patients with complete regression of IM after 8‐week celecoxib treatment had a significantly lower COX‐2 expression, but not β‐catenin expression, at enrollment than those patients without IM regression ( P = 0.031). Conclusion: Short‐term celecoxib treatment can be safe and promising to regress long‐term persistent IM after H. pylori eradication.