Although evidence suggests that aspirin and celecoxib may reduce the risk of esophageal adenocarcinoma in patients with Barrett's esophagus, these drugs can also cause harmful side effects.
Dr Chin Hur and colleagues from Massachusetts, USA determined and characterized preferences for these drugs in patients with Barrett's esophagus.
The team collected preference data from recruited Barrett's esophagus patients using a customized questionnaire, which incorporated standard risk communication techniques.
|76% stated that they would take aspirin|
|American Journal of Gastroenterology|
Summary profiles outlined the benefits and harms of celecoxib and aspirin presented anonymously.
Both drugs were portrayed as reducing the risk of esophageal adenocarcinoma and increasing the risk of gastrointestinal events.
The team found that celecoxib increased the risk of myocardial infarction, while aspirin reduced the risk.
Factors influencing patient acceptance of each drug were analyzed.
The researchers observed that 92% of subjects completed the study.
Under base case conditions, 15% stated that they would take celecoxib and 76% aspirin.
Patients identified the greater risk of myocardial infarction as the primary reason for their unwillingness to take celecoxib and the lower risk of esophageal adenocarcinoma for aspirin.
Even in scenarios in which the benefits of celecoxib were improved and the harms reduced, a majority continued to find it unacceptable.
Dr Hur’s team concluded, “A majority of those surveyed stated that they would take aspirin but would not take celecoxib.”
“Most patients are interested in esophageal adenocarcinoma chemoprevention, but the amount of protection and the side effect profile of a drug determine its acceptability.”
“These data can inform physicians regarding the tradeoffs patients are willing to consider for chemoprevention.”