Long-term Celecoxib can Prevent the Progression of Persistent Gastric Intestinal Metaplasia After H. pylori Eradication

Background and Aim Intestinal metaplasia (IM) has overexpressions of COX‐2. Short‐term 8‐week celecoxib, a selective COX‐2 inhibitor, exerts a preliminary hint to improve regression in part for persistent IM after Helicobacter pylori eradication. This study further validated whether or not a prolonged duration of celecoxib of up to 1 year can be safe and effective. Methods One hundred and forty patients, with persistent IM after H. pylori eradication for 1 year, were included with half of them receiving celecoxib 200 mg/day for 12 months and the other half serving as controls. Each patient received serial checkups of blood creatinine levels every 4 months. After the 1‐year follow‐up, panendoscopy was repeated to assess the IM regression. The serial gastric specimens, taken before and after celecoxib therapy, were immunochemically stained for COX‐2. Results The intention‐to‐treat (ITT) and per‐protocol (PP) analyses to the rates of IM regression were higher in the celecoxib group than in the controls (ITT: 44.3% [31/70] vs 14.3% [10/70], p