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Aspirin, eicosapentaenoic acid, and placebo equally effective in preventing colorectal adenomas in high-risk patients
Question clinique
Is either aspirin or eicosapentaenoic acid effective in preventing colorectal adenomas in patients with previous high-risk colorectal neoplasia?
L’Essentiel
After 12 months, neither aspirin nor eicosapentaenoic acid (EPA), alone or in combination, are any better than placebo at preventing colorectal adenomas in patients with high-risk neoplasia. 1b
Référence
Plan de l'etude: Randomized controlled trial (double-blinded)
Financement: Government
Cadre: Outpatient (any)
Sommaire
This study's title is a candidate for the year's most tortured acronym: The Systematic Evaluation of Aspirin and Fish Oil (seAFOod) Polyp Prevention Trial was a factorial trial that randomized patients with high-risk colorectal neoplasms detected on screening colonoscopy. The included patients had 3 or more adenomas, one of which had to be 1 cm in diameter, OR they had 5 or more smaller adenomas. The researchers randomized patients to receive EPA (1000 mg twice daily; n = 179) plus placebo, aspirin (300 mg daily; n = 177) plus placebo, EPA plus aspirin (n = 177); or placebo plus placebo (n = 176). The researchers performed a follow-up colonoscopy 12 months after enrollment. Sixty-six (9%) patients did not have a follow-up colonoscopy and were excluded from the analysis. The rate of subsequent adenomas at follow-up was high (61%-63%) and not statistically significantly different for each group. The rate of adverse events was low in all groups.
Reviewer
Henry C. Barry, MD, MS
Professor
Michigan State University
East Lansing, MI