Statins were associated with a reduced gastric cancer risk in patients with eradicated Helicobacter pylori infection: a territory-wide propensity score matched study
Menée à l'aide de données portant sur 63 605 patients ayant reçu un traitement d'éradication d'Helicobacter pylori (durée médiane de suivi : 7,6 ans), cette étude analyse l'effet des statines sur le risque de cancer de l'estomac (169 cas)
Background : Individuals may still develop gastric cancer (GC) even after H. pylori (HP) eradication. We aimed to investigate statin effect on GC development in HP-eradicated subjects. Methods : All adult subjects who were prescribed clarithromycin-based triple therapy between 2003 and 2012 were identified in this retrospective cohort study utilizing a territory-wide electronic healthcare database. Patients were observed from index date of HP therapy, and censored at GC diagnosis, death or December 2015 (study end date). Statin use was defined as ≥ 180-day use after index date. Exclusion criteria included GC diagnosed within the first year after index date, previous GC or gastrectomy, and HP treatment failure. Subdistribution hazard ratio (SHR) of GC with statins was calculated by competing risk regression with propensity score (PS) analysis matching 19 variables (age, sex, comorbidities and other drug usage including proton pump inhibitors, non-steroidal anti-inflammatory drugs, aspirin, cyclooxygenase-2 inhibitors, and metformin). Results : During a median follow-up of 7.6 years (IQR: 5.1-10.3), 169 (0.27%) of 63,605 patients developed GC at an incidence rate of 3.5 per 10,000 person-years. Among 22,870 PS-matched subjects, statins were associated with a lower GC risk (SHR 0.34; 95% CI:0.19-0.61), in a duration- and dose-response manner (p-trend<0.05). Conclusion : Statins associated a lower GC risk in a duration- and dose-response manner among HP-eradicated patients. Impact : This study provides evidence on the additional benefits of statins as chemopreventive agents against GC among HP-eradicated patients.