Mesalamine reduces risk of CRC among IBD patients

NEW YORK (Reuters Health) - In a case-control study, the anti-inflammatory drug mesalamine protected against the development of colorectal cancer (CRC) among patients with inflammatory bowel disease (IBD).

The results were presented Monday in Philadelphia at the 72nd annual scientific meeting of the American College of Gastroenterology.

"Other studies have also found that mesalamine reduces colon cancer risk," Dr. Ann L. Silverman noted in a telephone interview with Reuters Health. "It makes sense," she explained, "because whenever you have inflammation, like in IBD, you have increased cancer risk, and if you reduce inflammation you reduce the risk and that's what mesalamine does."

In a retrospective, case-control study, Dr. Silverman and colleagues from Henry Ford Hospital, Detroit, carefully matched 16 IBD patients (13 ulcerative colitis and 3 Crohn's disease) who developed colorectal cancer to 23 IBD patients (19 ulcerative colitis and 4 Crohn's disease) who did not develop colorectal cancer.

The researchers found that all of the ulcerative colitis controls (i.e., those that did not develop colorectal cancer) used mesalamine, while only 76.9% of the patients with ulcerative colitis who developed colorectal cancer used mesalamine (p = 0.028).

Conditional regression analysis showed that a cumulative dose of mesalamine over time totaling 5068 grams or more was associated with an 89% reduced risk of colorectal cancer (odds ratio, 0.11).

The researchers also found that colorectal cancer cases also used folate more often than controls, but this was not associated with a reduction in risk of colorectal cancer. There were no between-group differences in use of mercaptopurine, nonsteroidal anti-inflammatory agents or steroids.