Short-term celecoxib to regress long-term persistent gastric intestinal metaplasia after Helicobacter pylori eradication

J Gastroenterol Hepatol. 2010 Jan;25(1):48-53. doi: 10.1111/j.1440-1746.2009.05974.x. Epub 2009 Sep 27.

Abstract

Background and aim: The intestinal metaplasia (IM) has overexpressions of cyclooxygenase-2 (COX-2) and beta-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 beta-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 beta-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.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Atrophy
  • Biomarkers / blood
  • Blood Urea Nitrogen
  • Celecoxib
  • Creatinine / blood
  • Cyclooxygenase 2 / metabolism
  • Cyclooxygenase 2 Inhibitors / administration & dosage*
  • Cyclooxygenase 2 Inhibitors / adverse effects
  • Drug Administration Schedule
  • Female
  • Gastric Mucosa / drug effects*
  • Gastric Mucosa / enzymology
  • Gastric Mucosa / microbiology
  • Gastric Mucosa / pathology
  • Gastroscopy
  • Helicobacter Infections / drug therapy*
  • Helicobacter Infections / microbiology
  • Helicobacter Infections / pathology
  • Helicobacter pylori / pathogenicity*
  • Humans
  • Immunohistochemistry
  • Male
  • Metaplasia
  • Middle Aged
  • Pilot Projects
  • Pyrazoles / administration & dosage*
  • Pyrazoles / adverse effects
  • Sulfonamides / administration & dosage*
  • Sulfonamides / adverse effects
  • Time Factors
  • Treatment Outcome
  • beta Catenin / metabolism

Substances

  • Biomarkers
  • CTNNB1 protein, human
  • Cyclooxygenase 2 Inhibitors
  • Pyrazoles
  • Sulfonamides
  • beta Catenin
  • Creatinine
  • Cyclooxygenase 2
  • PTGS2 protein, human
  • Celecoxib