Department of General Practice, Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei, China.
Department of Gastrointestinal Surgery, Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei, China.
Clin Res Hepatol Gastroenterol. 2021 May;45(3):101552. doi: 10.1016/j.clinre.2020.09.013. Epub 2020 Oct 23.
Conflicting evidence exists regarding the effect of NSAIDs on the risk of Barrett's esophagus. The purpose of this study is to systematically assess this effect through a meta-analysis.
Accordingly, clinical studies on NSAID use and Barrett's esophagus risk were searched on PubMed, Embase, and the Cochrane Library. Following this, meta-analyses were conducted using the RevMan 5.3 software. The pooled odds ratio (OR) and corresponding 95% confidence interval (CI) were used as the effect size.
Seven eligible studies (one cohort study and six case-control studies) were included for the present meta-analysis by adopting a fixed-effect model, which demonstrated that NSAIDs could reduce Barrett's esophagus risk (OR: 0.84, 95%CI:0.75-0.94, P＜0.05). Moreover, subgroup analyses done according to sex showed that NSAIDs could reduce Barrett's esophagus risk in females (OR 0.85; 95% CI 0.73-0.99; P = 0.04), without heterogeneity between studies (P = 1.00 and I = 0%). However, this relationship was not evident in males (OR 0.85; 95% CI 0.68-1.07; P = 0.16).
Overall, this meta-analysis provided high quality evidence that use of NSAIDs is associated with a reduced risk of Barrett's esophagus. However, the presence of a sex-dependent difference remains to be clarified.
关于非甾体抗炎药（NSAIDs）对 Barrett 食管风险的影响，目前仍存在相互矛盾的证据。本研究旨在通过荟萃分析系统地评估这种影响。
因此，在 PubMed、Embase 和 Cochrane 图书馆中检索了关于 NSAID 使用与 Barrett 食管风险的临床研究。然后，使用 RevMan 5.3 软件进行荟萃分析。汇总的比值比（OR）和相应的 95%置信区间（CI）用作效应量。
通过采用固定效应模型，本研究纳入了 7 项符合条件的研究（1 项队列研究和 6 项病例对照研究）进行荟萃分析，结果表明 NSAIDs 可以降低 Barrett 食管的风险（OR：0.84，95%CI：0.75-0.94，P＜0.05）。此外，根据性别进行的亚组分析表明，NSAIDs 可以降低女性的 Barrett 食管风险（OR 0.85；95%CI 0.73-0.99；P = 0.04），且各研究间无异质性（P = 1.00 和 I = 0%）。然而，这种相关性在男性中并不明显（OR 0.85；95%CI 0.68-1.07；P = 0.16）。
总体而言，这项荟萃分析提供了高质量的证据，表明 NSAIDs 的使用与降低 Barrett 食管的风险相关。然而，性别依赖性差异的存在仍需进一步阐明。
