Related Experiment Video
Updated: Sep 6, 2025
Synthesis of a Borylated Ibuprofen Derivative Through Suzuki Cross-Coupling and Alkene Boracarboxylation Reactions
Published on: November 30, 2022
Effects of Cyclooxygenase-2 Inhibitors on Gastrointestinal Malignancies: a Systematic Review and Meta-analysis
Yuan-Xi Jiang1, Ying Chen1, Hui-Hui Sun1
1Department of Gastroenterology, Tongji Hospital Affiliated to Tongji University, No. 389, Xincun Road, Shanghai, 200065 China.
Abstract:
Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with a reduced risk of gastrointestinal malignancies, which is thought to be mediated mainly through the inhibition of cyclooxygenases-2 (COX-2). Due to the severe side effects of aspirin/NSAIDs, selective COX-2 inhibitors may be a more ideal choice. The objective is to evaluate the association of selective COX-2 inhibitors with gastrointestinal (GI) malignancies and premalignant lesions. We searched for published manuscripts evaluating the association between COX-2 inhibitors and GI malignancies or precancerous lesion. Two investigators independently abstracted the data; then, we conducted the analysis by Review Manager V.5.0; evaluation of effectiveness was performed by an intention to treat (ITT) method. Selective COX-2 inhibitors had no beneficial effects on the progression or regression of esophageal and gastric dysplasia (OR = 1.06, 95% CI 0.63-1.78, P = 0.83 for regression of esophageal dysplasia; OR = 1.06, 95% CI 0.58-1.91, P = 0.86 for progression of esophageal dysplasia; OR = 1.95, 95%CI 0.92-4.17, P = 0.08 for regression of gastric dysplasia; and OR = 0.99, 95%CI 0.68-1.43, P = 0.94 for progression of gastric dysplasia). There is no protective effect on colorectal cancer (OR = 0.89, 95% CI 0.77-1.03, P = 0.11), and the use could not improve the effect of chemoradiation (OR = 1.20, 95% CI 0.46-3.19, P = 0.71). This pooled analysis indicates no meaningful association between selective COX-2 inhibitors and GI malignancies.
Insights
Selective COX-2 inhibitors do not prevent gastrointestinal malignancies or precancerous lesions. This analysis found no meaningful association between these drugs and GI cancer risk or progression.
Area of Science:
- Gastroenterology
- Oncology
- Pharmacology
Background:
- Aspirin and NSAIDs reduce GI cancer risk, potentially via COX-2 inhibition.
- Severe side effects of aspirin/NSAIDs necessitate exploring selective COX-2 inhibitors.
- Selective COX-2 inhibitors offer a potential alternative with fewer adverse effects.
Purpose of the Study:
- To evaluate the association between selective COX-2 inhibitors and gastrointestinal (GI) malignancies.
- To assess the impact of selective COX-2 inhibitors on GI precancerous lesions.
- To determine the efficacy of selective COX-2 inhibitors in preventing GI cancer progression.
Main Methods:
- Systematic review of published manuscripts on COX-2 inhibitors and GI malignancies/precancerous lesions.
- Independent data abstraction by two investigators.
- Meta-analysis using Review Manager V.5.0 with intention-to-treat (ITT) evaluation.
Main Results:
- Selective COX-2 inhibitors showed no significant effect on esophageal or gastric dysplasia progression or regression.
- No protective effect was observed against colorectal cancer (OR=0.89, P=0.11).
- Selective COX-2 inhibitors did not improve the efficacy of chemoradiation for GI cancers (OR=1.20, P=0.71).
Conclusions:
- Selective COX-2 inhibitors demonstrate no meaningful association with the prevention or treatment of GI malignancies.
- The use of selective COX-2 inhibitors does not appear to offer a beneficial effect on GI precancerous lesions.
- Further research may be needed to clarify the role, if any, of selective COX-2 inhibitors in GI oncology.
More Related Videos
Related Concept Videos
01:20Drugs for Peptic Ulcer Disease: Prostaglandin Analogs as Mucosal Protective Agents
Non-steroidal anti-inflammatory drugs (NSAIDs) can induce peptic ulcers by inhibiting cyclooxygenase, decreasing...
01:17Gastritis-II: Pathophysiology
In acute gastritis, the gastric mucosa becomes swollen and red and undergoes superficial erosion. Superficial ulceration may lead to bleeding.
In chronic gastritis, persistent or repeated insults lead to chronic inflammatory changes and, eventually, thinning or atrophy of the gastric tissue.
Gastritis can stem from various causes, each...
01:24Drugs for Peptic Ulcer Disease: Sucralfate as Mucosal Protective Agents
In this scenario, mucosal protective agents like sucralfate play an essential role. Sucralfate, a complex of sulfated sucrose and aluminum hydroxide, demonstrates its usefulness in acidic conditions,...
01:26Peptic Ulcer Disease IV: Management
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
01:29Drugs for Treatment of Ulcerative Colitis in IBD
01:28Peptic Ulcer Disease II: Pathophysiology
Damaging agents such as Helicobacter pylori, gastric acid, pepsin, and nonsteroidal anti-inflammatory drugs (NSAIDs) can weaken the mucosal defense, allowing hydrogen ions to infiltrate back and harm epithelial cells.