Chemopreventive Effect of Rebamipide against Gastric Cancer in Patients who undergo Endoscopic Resection for Early Gastric Neoplasms: A Nationwide Claims Study

Chemopreventive Effect of Rebamipide against Gastric Cancer in Patients who undergo Endoscopic Resection for Early Gastric Neoplasms: A Nationwide Claims Study
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DOI:
10.1159/000495288
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发表时间:
2019-11-01
期刊:
影响因子:
3.2
通讯作者:
Lee, Hyuk
Lee, Hyuk
中科院分区:
医学3区
文献类型:
--
作者:
Seo, GiHyeon;Lee, Hyuk

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背景/目标:先前的研究表明瑞巴派特对胃癌具有潜在的保护作用;然而,尚未对其在胃癌高危患者中的化学预防作用进行流行病学研究。本研究的目的是调查瑞巴派特是否能降低胃癌的风险。研究方法:我们使用从韩国健康保险审查和评估服务数据库中回顾性收集的数据进行了一项基于人群的队列研究。纳入了2011年至2014年间因早期胃肿瘤接受内镜粘膜下剥离术(ESD)的患者。结果如下:在73,416人年的随访中,711例患者新诊断为胃癌,包括377例低剂量(低于中位数)和334例高剂量(高于中位数)瑞巴派特使用者(分别为37,157.4和36,258.3/100,000人年;对数秩检验,p = 0.052)。根据年龄、性别和初次诊断时的指数ESD,胃癌发病率存在显著差异。调整这些临床因素后,高剂量使用与胃癌风险降低相关(风险比0.858; 95%CI 0.739-0.995,p = 0.043)。结论:高剂量瑞巴派特与接受早期胃肿瘤内镜切除术的高危人群胃癌风险降低相关。(C)2018 S. Karger AG,巴塞尔
Background/Aims: Previous studies have shown that rebamipide is potentially protective against gastric cancer; however, no epidemiologic studies of its chemopreventive effects in patients who have a high risk of gastric cancer have been performed. The aim of this study was to investigate whether rebamipide administration reduces the risk of gastric cancer. Methods: We conducted a population-based cohort study using data retrospectively collected from the Health Insurance Review and Assessment Service database in Korea. Patients who underwent endoscopic submucosal dissection (ESD) for early gastric neoplasms between 2011 and 2014 were included. Results: During 73,416 person-years of follow-up, 711 patients were newly diagnosed with gastric cancer, including 377 low-dose (below median) and 334 high-dose (above median) rebamipide users (37,157.4 and 36,258.3 per 100,000 person-years, respectively; log-rank test, p = 0.052). There were significant differences in gastric cancer incidence rates according to age, sex, and initial diagnosis at the time of index ESD. After adjusting for these clinical factors, high-dose use was associated with a reduced risk of gastric cancer (hazard ratio 0.858; 95% CI 0.739-0.995, p = 0.043). Conclusion: High-dose rebamipide is associated with reduced gastric cancer risk in high-risk populations who undergo endoscopic resection for early gastric neoplasms. (C) 2018 S. Karger AG, Basel