Effect of nonsteroidal anti-inflammatory drugs on Barrett's esophagus risk: a systematic review and meta-analysis

Abstract

ObjectiveConflicting 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. MethodsAccordingly, 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. ResultsSeven 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 I2 = 0%). However, this relationship was not evident in males (OR 0.85; 95% CI 0.68–1.07; P = 0.16). ConclusionsOverall, 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.