Review supports protective effect of COX-2s but not statins against
colorectal cancer
Patients who take cyclo-oxygenase-2 (COX-2) inhibitors have a reduced
risk of developing colorectal cancer (CRC), suggests a retrospective
analysis of UK general practice data.
The study was carried out by primary care researchers at the University
of Nottingham after suggestions that statins might prevent some cancers — with
one study suggesting a 47 per cent reduction in colorectal cancer.
Using the QRESEARCH database from 454 practices, they looked at the chances
of CRC developing in 5,686 patients prescribed a statin, a non-steroidal
anti-inflammatory drug (NSAID), a COX-2 inhibitor or aspirin compared
with almost 25,000 matched controls.
Richard Logan, professor of clinical epidemiology at Nottingham, said
they were surprised to find that there was no significant drop in CRC
risk associated with statins. But patients taking COX-2 inhibitors for
a prolonged period — more than 25 prescriptions — had a 66
per cent lower risk of developing CRC. For prolonged exposure to NSAIDs
the drop was 24 per cent.
Professor Logan added: “We have to stress that compared with the
other treatments there was little prolonged use of COX-2 inhibitors but
this large study suggests there is a significant drop in the risk of
CRC, with a smaller but still significant drop with NSAIDs.”
It was the use of rofecoxib (Vioxx) to prevent polyp recurrence in patients
successfully treated for CRC that led to its withdrawal due to an increase
number of cardiovascular events.
Commenting on the data, Colm O’Morain, consultant gastroenterologist
and professor of medicine at Trinity College Dublin, said: “There
are still hopes that COX-2s could prove useful for secondary prevention
of CRC and there are still large ongoing trials into this use. But there
is undoubtedly a cardiovascular risk to bear in mind especially as you’ll
be taking this drug for the rest of your life.”
The data were presented at the United European Gastroenterology Week
meeting held in Berlin last week. |
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Pharmaceutical Journal
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