The Pharmaceutical Journal
Vol 269 No 7222 p634
2 November 2002

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United European Gastro-enterology Week congress (www.uegf.org)

Mesalazine prophylaxis could be used to prevent colorectal cancer

Evidence is building that prophylaxis with mesalazine (5-aminosalicylic acid, 5-ASA) is effective in preventing colorectal cancer in patients with inflammatory bowel disease (IBD), according to a leading gastroenterologist.

Adressing the United European Gastro-enterology Week congress in Geneva last week, Dr Jayne Eaden, one of the authors of the British Society of Gastroenterology guidelines on cancer surveillance in IBD, presented a review of evidence which suggests that mesalazine is the only treatment to be associated with a statistically significant reduction in the risk of developing cancer in patients with ulcerative colitis.

Odds ratios for developing cancer in IBD patients taking mesalazine were as low as 0.08, compared with 0.40 with other drugs such as sulfasalazine and olsalazine. Dr Eaden, who is a consultant gastroenterologist at Walsgrave Hospital in Coventry, is planning to set up a UK-wide study to examine the possibility of using the drug routinely in these patients.

She believes that being able to tell patients that the drugs they are taking for symptomatic relief of IBD symptoms are protecting them from cancer could increase compliance: "In Denmark, where ASA prophylaxis is routine in these patients, there is evidence of a very low risk of colorectal cancer and that it is even a cost-effective intervention when compared with surgery."

Dr Eaden added that current UK practice, of checking for neoplasms using colonoscopy, had little evidence to back it up. "There is no randomised controlled trial showing it works and we know that the type of neoplasms in patients with ulcerative colitis look different anyway," she told delegates.