Eicosapentaenoic acid reduces rectal polyp number and size in familial adenomatous polyposis - PubMed (original) (raw)
Randomized Controlled Trial
doi: 10.1136/gut.2009.200642. Epub 2010 Mar 26.
Affiliations
- PMID: 20348368
- DOI: 10.1136/gut.2009.200642
Randomized Controlled Trial
Eicosapentaenoic acid reduces rectal polyp number and size in familial adenomatous polyposis
Nicholas J West et al. Gut. 2010 Jul.
Abstract
Objective: The omega-3 polyunsaturated fatty acid eicosapentaenoic acid (EPA) has anticolorectal cancer activity in vitro and in preclinical models. The present study tested whether a novel, enteric-coated formulation of EPA, as the free fatty acid (EPA-FFA), has chemopreventative efficacy in patients with familial adenomatous polyposis (FAP), in a randomised, double-blind, placebo-controlled trial.
Methods: Patients undergoing endoscopic surveillance of their retained rectum postcolectomy were randomised to EPA-FFA (SLA Pharma) 2 g daily or placebo for 6 months. The number and size of polyps in an area of mucosa defined by a tattoo were determined before and after intervention. Global rectal polyp burden was scored (-1, 0, +1) by examination of video endoscopy records. Mucosal fatty acid content was measured by gas chromatography-mass spectrometry.
Results: 55 patients with FAP were evaluated by an intention-to-treat analysis (EPA-FFA 28, placebo 27). Treatment with EPA-FFA for 6 months was associated with a mean 22.4% (95% CI 5.1% to 39.6%) reduction in polyp number (p=0.012) and a 29.8% (3.6% to 56.1%) decrease in the sum of polyp diameters (p=0.027). Global polyp burden worsened over 6 months in the placebo group (-0.34) unlike the EPA-FFA group (+0.09, difference 0.42 (0.10-0.75), p=0.011). EPA-FFA treatment led to a mean 2.6-fold increase in mucosal EPA levels (p=0.018 compared with placebo). EPA-FFA was well tolerated with an incidence of adverse events similar to placebo.
Conclusions: EPA-FFA has chemopreventative efficacy in FAP, to a degree similar to that previously observed with selective cyclo-oxygenase-2 inhibitors. EPA holds promise as a colorectal cancer chemoprevention agent with a favourable safety profile.
Trial registration: ClinicalTrials.gov NCT00510692.
Comment in
- Eicosapentaenoic acid and chemoprevention of FAP.
Lynch PM. Lynch PM. Gut. 2010 Jul;59(7):871-3. doi: 10.1136/gut.2009.204677. Gut. 2010. PMID: 20581233 No abstract available.
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