Takeaway
- Use of cyclooxygenase (COX) inhibitors is tied to a decreased risk for hepatocellular carcinoma (HCC) in patients with HBV.
- The effect appears to be dose dependent.
Why this matters
- COX expression in cancer tissues varies from 40% to 100%, and evidence suggests that COX-2 inhibition plays a chemopreventive role in colon, breast, prostate, and lung cancer.
Study design
- Nested case-control study of 4980 HBV-infected patients from the Korean National Health Insurance Service-National Sample Cohort (2002-2013).
- 996 patients with HCC were matched with 3984 control patients based on clinical and demographic factors; mean age was 51.2 years.
- COX inhibitor use was stratified by cumulative defined daily dose (cDDD) <28, 28-90, 91-180, 181-360, and >360 mg.
- Funding: None.
Key results
- COX inhibitors were used (≥28 cDDD) by 35.9% of patients with HCC and 45.5% of control patients; mean follow-up was 4.63 and 5.06 years, respectively.
- Exposure to COX inhibitors was tied to a 38% reduced odds of HCC development (aOR, 0.62; P<.001).
- Odds of HCC generally declined with increasing cDDD:
- 28-90 mg: 25% risk reduction (aOR, 0.75; P=.002).
- 91-180 mg: 59% risk reduction (aOR, 0.41; P<.001).
- 181-360 mg: 62% risk reduction (aOR, 0.38; P<.001).
- >360 mg: 51% risk reduction (aOR, 0.49; P=.003).
Limitations
- Observational design.
- Clinical data were not captured by claim information.
- Low use of selective COX-2 inhibitors (2.3%-2.8%).
References
References
