Low-dose aspirin and mesalazine for patients with familial adenomatous polyposis
Mené au Japon auprès de 104 patients atteints d'une polypose adénomateuse familiale (âge : 16 à 70 ans), cet essai multicentrique randomisé évalue l'efficacité, du point de vue de la réduction de l'incidence des polypes colorectaux de taille supérieure ou égale à 5mm, et la toxicité d'une faible dose d'aspirine, de la mésalazine ou d'un traitement combinant les deux
Key issues in colorectal adenoma chemoprevention revolve around drug efficacy and safety. In the case of familial adenomatous polyposis, these issues must be considered in the context of patients. One group are young patients, aged 10–20 years, undergoing regular colonoscopy to assess the emergence of adenomas. A second group are these same patients, now a bit older, having undergone colectomy or proctocolectomy, but who are at risk of recurrent adenomas and ultimately of cancer of the rectum or ileal pouch, as well as the duodenum. They might require an operation more morbid, owing to scars and even desmoid tumours associated with such previous surgery, than the original colectomy. In precolectomy and postcolectomy patients, the ultimate goal of chemoprevention must be to prevent or slow the growth of adenomas, thereby attenuating risk of cancer. This approach would reduce the need for or delay such surgery, also potentially decreasing the frequency of surveillance endoscopy.