Low-dose aspirin safe in patients undergoing radiofrequency ablation for Barrett's esophagus

SAN DIEGO — Patients undergoing radiofrequency ablative therapy for Barrett’s esophagus complicated by dysplasia appear to be safe in taking low-dose aspirin, although there was no difference between aspirin users and nonusers in terms of remission of dysplasia and intestinal metaplasia, a speaker said here.

“Low-dose aspirin showed that there was no benefit in achieving complete remission of metaplasia or complete remission of dysplasia after RFA [radiofrequency ablative] treatment, suggesting that at least low-dose aspirin probably doesn’t have that dramatic of an effect,” researcher Daniel K. Chan, MD, of Mayo Clinic in Rochester, Minn., said during the American College of Gastroenterology Annual Scientific Meeting.

When researchers combined low-dose and full-dose aspirin users and removed those on nonsteroidal anti-inflammatory drug therapy, Chan said there was a “small but significant association with people achieving remission from dysplasia, suggesting that aspirin may have an effect overall in helping people achieve remission of the disease.” Further prospective studies are needed to demonstrate any dosage correlation, he said.

For the retrospective analysis, researchers examined records of 162 patients who underwent RFA for Barrett’s esophagus with high grade dysplasia/intramucosal adenocarcinoma at a tertiary referral center. One hundred sixty patients were on proton-pump inhibitor therapy while undergoing RFA, and 64 of them were using low-dose aspirin for a mean of 21 months before RFA, the researchers wrote.

The same proportion of aspirin and nonaspirin users achieved complete remission of intestinal metaplasia (CRIM; 59% of each group) with no difference in time to achieve CRIM. More aspirin users achieved complete remission of dysplasia, but the difference (83% vs. 71%) was not significant.

There also was no difference between groups for adverse events including stricture formation.

Disclosure: Chan reports no relevant financial disclosures.

For more information:

Chan D. #1222: Low Dose Aspirin Does Not Affect Outcomes from Radiofrequency Ablation for Barrett’s Esophagus. Presented at: the 2013 American College of Gastroenterology Annual Scientific Meeting; Oct. 11-16, San Diego.

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