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Drug efficacy

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[1], 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

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