Posted on Jun 13, 2018, 7 p.m.
Barrett’s esophagus patient’s risk for developing esophageal cancer has been shown to be reduced by aspirin and esomeprazole combination, according to results of a phase III ASPECT trial.
When taken regularly low dose aspirin combined with high dose esomeprazole can moderately lessen risk of high grade esophageal cancer in patients diagnosed with Barrett’s esophagus when taken for at least 7 years. Combination of the two over the counter medicines can reduce the all cause mortality: high dose esomeprazole is a proton pump inhibitor acting to suppress production of gastric acids.
Improvement over time to all cause of death after diagnosis with esophageal cancer or high grade dysplasia after medical follow up after 8.9 years has been shown to be provided by using the high dose of esomeprazole at 40 mg twice a day in combination with low dose aspirin, as compared to the standard dose of esomeprazole at 20 mg once a day.
Esophageal cancer can develop due to long term GERD, risk is highest among those with Barrett’s esophagus, as acids tend to damage squamous mucosa lining the esophagus, and when lesions heal columnar cells are replace with squamous ones. Approximately 2% of the population will be affected by Barrett’s esophagus, and in 80-90% of cases gives rise to esophageal cancers.
Researchers say that the actual effect may seem small because of the small incidence rate, but the impact of the findings is huge on the patients affected. According to the SEER Program incidence of esophageal cancer is 1% of all new cancers within the USA, with an estimated survival rate of 19.2%, and an estimated 17290 will be diagnosed this year. Another 9211 new cases will be diagnosed within the UK according to Cancer Research UK.
2563 patients with over 1 cm of Barrett’s esophagus were involved in this study. Participants were given either high or low dose esomeprazole alone or in combination with either 300 or 330 mg of aspirin, and continued medications for 8-10 years. Few adverse events were seen with the medications at less than 1%. Results are important as for a drug to prevent a disease it needs to be taken for an extended period of time to be proven safe so that the benefits are more than the risks.
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