Non-aspirin NSAIDs outperform aspirin for colorectal cancer prevention
Non-aspirin NSAIDs offer protection against colorectal cancer but carry a high risk of adverse events.
Research has indicated that non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin, have a protective effect against the development of colorectal cancer in patients with previous neoplasia. But the relative efficacy of different pharmaceutical agents is unknown.
To seek clarity, researchers performed a network meta-analysis of data from 14 clinical trials involving 12,234 patients who had previously been treated for colorectal polyps or cancer.
Reporting in The BMJ, they found that, compared with placebo, non-aspirin NSAIDs were superior for preventing advanced metachronous neoplasia over follow-up of three to five years. Low-dose aspirin was ranked second for efficacy, but had the most favourable risk-benefit profile.
As non-aspirin NSAIDs carry a high risk of serious adverse events, the authors suggest that low-dose aspirin might therefore be preferable for all patients except those with previous high-risk neoplasia.
Citation: Clinical Pharmacist DOI: 10.1211/CP.2017.20202251