T P van Staa1, T Card, R F Logan, H G M Leufkens. 1. Division of Epidemiology and Public Health, School of Community Health Sciences, University of Nottingham Medical School, Nottingham NG7 2UH, UK.
Abstract
BACKGROUND AND AIMS: The objective of this study was to evaluate the risk of colorectal cancer (CRC) in patients taking aminosalicylates (5-ASA) for inflammatory bowel disease (IBD). METHODS: The General Practice Research Database (GPRD) which contains the primary care records of five million people in the UK was used to identify users of mesalazine, balsalazide, olsalazine, or sulfasalazine with a history of IBD. In a nested case control analysis, each incident CRC case with any use of a 5-ASA in the six months before the CRC diagnosis was matched by age, sex, and calendar time to six control patients who were also currently using a 5-ASA. Patients were then classified according to regularity of use. The analysis was controlled for body mass index, IBD duration, history of colorectal polyps, use of non-steroidal anti-inflammatory drugs, paracetamol, aspirin, immunosuppressants, oral and rectal glucocorticoids, prior gastrointestinal hospitalisation, recorded colonoscopy, and number of visits to the general practitioner for IBD symptoms in the 6-24 months before diagnosis. RESULTS: The study population included 18 969 patients, of whom 100 had developed CRC during 5-ASA exposure. Most of these cases had a history of ulcerative colitis (76 patients). In the case control analysis, regular users, defined as having six or more 5-ASA prescriptions in the previous 12 months, were found to have a decreased risk of CRC compared with irregular users (crude odds ratio (OR) 0.7 (0.44-1.03); adjusted OR 0.60 (0.38-0.96)). Regular users of sulfasalazine with 6-12 prescriptions before had an adjusted OR of 0.95 (0.22-4.11); with 13-30 prior prescriptions this was 0.41 (0.14-1.20) and with >30 prior prescriptions this was 0.77 (0.37-1.60). For mesalazine users, these values were 1.13 (0.49-2.59), 0.30 (0.11-0.83), and 0.31 (0.11-0.84), respectively. CONCLUSION: These results show that regular 5-ASA use is associated with some reduction in the risk of CRC developing in ulcerative colitis.
BACKGROUND AND AIMS: The objective of this study was to evaluate the risk of colorectal cancer (CRC) in patients taking aminosalicylates (5-ASA) for inflammatory bowel disease (IBD). METHODS: The General Practice Research Database (GPRD) which contains the primary care records of five million people in the UK was used to identify users of mesalazine, balsalazide, olsalazine, or sulfasalazine with a history of IBD. In a nested case control analysis, each incident CRC case with any use of a 5-ASA in the six months before the CRC diagnosis was matched by age, sex, and calendar time to six control patients who were also currently using a 5-ASA. Patients were then classified according to regularity of use. The analysis was controlled for body mass index, IBD duration, history of colorectal polyps, use of non-steroidal anti-inflammatory drugs, paracetamol, aspirin, immunosuppressants, oral and rectal glucocorticoids, prior gastrointestinal hospitalisation, recorded colonoscopy, and number of visits to the general practitioner for IBD symptoms in the 6-24 months before diagnosis. RESULTS: The study population included 18 969 patients, of whom 100 had developed CRC during 5-ASA exposure. Most of these cases had a history of ulcerative colitis (76 patients). In the case control analysis, regular users, defined as having six or more 5-ASA prescriptions in the previous 12 months, were found to have a decreased risk of CRC compared with irregular users (crude odds ratio (OR) 0.7 (0.44-1.03); adjusted OR 0.60 (0.38-0.96)). Regular users of sulfasalazine with 6-12 prescriptions before had an adjusted OR of 0.95 (0.22-4.11); with 13-30 prior prescriptions this was 0.41 (0.14-1.20) and with >30 prior prescriptions this was 0.77 (0.37-1.60). For mesalazine users, these values were 1.13 (0.49-2.59), 0.30 (0.11-0.83), and 0.31 (0.11-0.84), respectively. CONCLUSION: These results show that regular 5-ASA use is associated with some reduction in the risk of CRC developing in ulcerative colitis.
Authors: Charles N Bernstein; Jayne Eaden; A Hillary Steinhart; Pia Munkholm; Philip H Gordon Journal: Inflamm Bowel Dis Date: 2002-09 Impact factor: 5.325
Authors: Robert S Sandler; Susan Halabi; John A Baron; Susan Budinger; Electra Paskett; Roger Keresztes; Nicholas Petrelli; J Marc Pipas; Daniel D Karp; Charles L Loprinzi; Gideon Steinbach; Richard Schilsky Journal: N Engl J Med Date: 2003-03-06 Impact factor: 91.245
Authors: P J Bus; I D Nagtegaal; H W Verspaget; C B Lamers; H Geldof; J H Van Krieken; G Griffioen Journal: Aliment Pharmacol Ther Date: 1999-11 Impact factor: 8.171
Authors: A Reinacher-Schick; F Seidensticker; S Petrasch; M Reiser; S Philippou; D Theegarten; G Freitag; W Schmiegel Journal: Endoscopy Date: 2000-03 Impact factor: 10.093
Authors: Matthew Rutter; Brian Saunders; Kay Wilkinson; Steve Rumbles; Gillian Schofield; Michael Kamm; Christopher Williams; Ashley Price; Ian Talbot; Alastair Forbes Journal: Gastroenterology Date: 2004-02 Impact factor: 22.682
Authors: Christopher Ma; Carla Ascoytia; Kelly P McCarrier; Mona Martin; Brian G Feagan; Vipul Jairath Journal: Dig Dis Sci Date: 2018-06-29 Impact factor: 3.199