BACKGROUND: Sulindac, a non-steroidal anti-inflammatory drug, causes regression of colorectal adenomas in patients with familial adenomatous polyposis (FAP) but the response is variable. Specific clinical factors predictive of sulindac induced regression have not been studied. METHODS: 22 patients with FAP were given sulindac 150 mg orally twice a day. Polyp number and size were determined before treatment and at three months. The relation of nine clinical factors to polyp regression (per cent of baseline polyp number after treatment) was evaluated by univariate and multivariate analysis. RESULTS: After three months of sulindac, polyp number had decreased to 45 per cent of baseline and polyp size to 50 per cent of baseline (p < 0.001 and p < 0.01, respectively). Univariate analysis showed greater polyp regression in older patients (p = 0.004), those with previous colectomy and ileorectal anastomosis (p = 0.001), and patients without identifiable mutation of the APC gene responsible for FAP (p = 0.05). With multivariate regression analysis, response to sulindac treatment was associated with previous subtotal colectomy. CONCLUSIONS: Sulindac treatment seems effective in producing regression of colorectal adenomas of FAP patients with previous subtotal colectomy regardless of baseline polyp number and size. Changed sulindac metabolism, reduced area of the target mucosa, or changed epithelial characteristics after ileorectal anastomosis may explain these findings.
BACKGROUND:Sulindac, a non-steroidal anti-inflammatory drug, causes regression of colorectal adenomas in patients with familial adenomatous polyposis (FAP) but the response is variable. Specific clinical factors predictive of sulindac induced regression have not been studied. METHODS: 22 patients with FAP were given sulindac 150 mg orally twice a day. Polyp number and size were determined before treatment and at three months. The relation of nine clinical factors to polyp regression (per cent of baseline polyp number after treatment) was evaluated by univariate and multivariate analysis. RESULTS: After three months of sulindac, polyp number had decreased to 45 per cent of baseline and polyp size to 50 per cent of baseline (p < 0.001 and p < 0.01, respectively). Univariate analysis showed greater polyp regression in older patients (p = 0.004), those with previous colectomy and ileorectal anastomosis (p = 0.001), and patients without identifiable mutation of the APC gene responsible for FAP (p = 0.05). With multivariate regression analysis, response to sulindac treatment was associated with previous subtotal colectomy. CONCLUSIONS:Sulindac treatment seems effective in producing regression of colorectal adenomas of FAPpatients with previous subtotal colectomy regardless of baseline polyp number and size. Changed sulindac metabolism, reduced area of the target mucosa, or changed epithelial characteristics after ileorectal anastomosis may explain these findings.
Authors: Y Miyoshi; H Ando; H Nagase; I Nishisho; A Horii; Y Miki; T Mori; J Utsunomiya; S Baba; G Petersen Journal: Proc Natl Acad Sci U S A Date: 1992-05-15 Impact factor: 11.205
Authors: K W Kinzler; M C Nilbert; L K Su; B Vogelstein; T M Bryan; D B Levy; K J Smith; A C Preisinger; P Hedge; D McKechnie Journal: Science Date: 1991-08-09 Impact factor: 47.728
Authors: L J Hixson; D S Alberts; M Krutzsch; J Einsphar; K Brendel; P H Gross; N S Paranka; M Baier; S Emerson; R Pamukcu Journal: Cancer Epidemiol Biomarkers Prev Date: 1994 Jul-Aug Impact factor: 4.254
Authors: F M Giardiello; S R Hamilton; A J Krush; S Piantadosi; L M Hylind; P Celano; S V Booker; C R Robinson; G J Offerhaus Journal: N Engl J Med Date: 1993-05-06 Impact factor: 91.245
Authors: S M Powell; G M Petersen; A J Krush; S Booker; J Jen; F M Giardiello; S R Hamilton; B Vogelstein; K W Kinzler Journal: N Engl J Med Date: 1993-12-30 Impact factor: 91.245
Authors: V W Yang; D E Geiman; W C Hubbard; E W Spannhake; L M Hylind; S R Hamilton; F M Giardiello Journal: Prostaglandins Other Lipid Mediat Date: 2000-01 Impact factor: 3.072
Authors: Irfan M Hisamuddin; Mohammad A Wehbi; Brian Schmotzer; Kirk A Easley; Linda M Hylind; Francis M Giardiello; Vincent W Yang Journal: Cancer Epidemiol Biomarkers Prev Date: 2005-10 Impact factor: 4.254
Authors: J J Keller; G J Offerhaus; M Polak; S N Goodman; M L Zahurak; L M Hylind; S R Hamilton; F M Giardiello Journal: Gut Date: 1999-12 Impact factor: 23.059
Authors: Natalia A Ignatenko; David G Besselsen; Upal K Basu Roy; David E Stringer; Karen A Blohm-Mangone; Jose L Padilla-Torres; Jose M Guillen-R; Eugene W Gerner Journal: Nutr Cancer Date: 2006 Impact factor: 2.900