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

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

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1
Institute of Basic Medical Sciences, National Cheng Kung University, Hsinchu, Taiwan.

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.

[Indexed for MEDLINE]

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