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aspirin & colorectal polyps

randomized, double blind, placebo-controlled trials #1 - 635 patients with previously resected colorectal carcinoma - 31 month follow-up - aspirin 325 mg QD vs placebo - 1-2 colonoscopies - aspirin recipients significantly less liekly to develop 2 or - more adenomatous polyps (17% vs 37%) - adverse effects similar in both groups #2 - 1121 patients with previously resected adenomatous polyp - 31 month average follow-up - aspirin 81 mg, 325 mg or placebo - at least 1 adenoma detected in a) 38% (81 mg QD aspirin)* b) 45% (325 mg QD aspirin) c) 47% placebo Only 81 mg of aspirin significantly different from placebo Non significant trend toward more adverse effect in aspirin groups than placebo groups #3 - aspirin 300 mg QD lowered risk of right-sided adenomas (RR=0.75) [3]

References

  1. Journal Watch 23(8):62, 2003 Sandler RS et al, N Engl J Med 348:883, 2003 Baron JA et al, N Engl J Med 348:891, 2003 Imperiale, N Engl J Med 348:879, 2003
  2. Prescriber's Letter 9(5):29 2002
  3. Hull MA, Sprange K, Hepburn T et al. Eicosapentaenoic acid and aspirin, alone and in combination, for the prevention of colorectal adenomas (seAFOod Polyp Prevention trial): A multicentre, randomised, double-blind, placebo-controlled, 2 2 factorial trial. Lancet 2018 Dec 15; 392:2583. PMID: 30466866 Free full text https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31775-6/fulltext - Dekker E, Kaminski MF. Take a pill for no more polyps: Is it that simple? Lancet 2018 Dec 15; 392:2519. PMID: 30466865 Free Article https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32322-5/fulltext