Long-term treatment with sulindac in familial adenomatous polyposis

A prospective cohort study

Marcia CruzCorrea, Linda M. Hylind, Katharine E. Romans, Susan V. Booker, Francis M Giardiello

Research output: Contribution to journalArticle

Abstract

Background and Aims: Management of patients with familial adenomatous polyposis (FAP) can consist of colectomy with ileorectal anastomosis (IRA). Sulindac, a nonsteroidal anti-inflammatory drug, causes regression of colorectal adenomas in the retained rectal segment of FAP patients, although long-term use of this therapy has not been studied. We evaluated the long-term effectiveness and toxicity of sulindac in attempting to maintain retained rectal segments free of adenomas. Methods: Twelve FAP patients (5 women), mean age 37.1 years, with IRA received sulindac (mean dosage, 158 mg/day) for a mean period of 63.4 ± 31.3 months (range, 14-98 months). Number, size, and histologic grade of polyps, side effects, and medication compliance were assessed every 4 months. Results: Seven of 12 patients (58%) remained in the study (6 of these polyp-free) for a mean of 76.9 ± 27.5 months. Five of 12 patients (42%) withdrew from the trial after a mean follow-up period of 44 ± 28 months (range, 14-89 months). A significant regression of polyp number was observed in all patients at 12 months (P = 0.039) and at a mean of 63.4 ± 31.3 months (P = 0.006). Prevention of recurrence of higher-grade adenomas (tubulovillous, villous adenomas) was also observed (P = 0.004). At 35 months of follow-up, 1 patient developed stage III cancer in the rectal stump. The most common side effect was rectal mucosal erosions in 6 patients. Conclusions: Long-term use of sulindac seems to be effective in reducing polyp number and preventing recurrence of higher-grade adenomas in the retained rectal segment of most FAP patients. Erosions at the IRA site can preclude adequate dose maintenance.

Original languageEnglish (US)
Pages (from-to)641-645
Number of pages5
JournalGastroenterology
Volume122
Issue number3
StatePublished - 2002

Fingerprint

Sulindac
Adenomatous Polyposis Coli
Cohort Studies
Prospective Studies
Polyps
Adenoma
Therapeutics
Villous Adenoma
Recurrence
Medication Adherence
Colectomy
Rectal Neoplasms
Anti-Inflammatory Agents
Maintenance

ASJC Scopus subject areas

  • Gastroenterology

Cite this

CruzCorrea, M., Hylind, L. M., Romans, K. E., Booker, S. V., & Giardiello, F. M. (2002). Long-term treatment with sulindac in familial adenomatous polyposis: A prospective cohort study. Gastroenterology, 122(3), 641-645.

Long-term treatment with sulindac in familial adenomatous polyposis : A prospective cohort study. / CruzCorrea, Marcia; Hylind, Linda M.; Romans, Katharine E.; Booker, Susan V.; Giardiello, Francis M.

In: Gastroenterology, Vol. 122, No. 3, 2002, p. 641-645.

Research output: Contribution to journalArticle

CruzCorrea, M, Hylind, LM, Romans, KE, Booker, SV & Giardiello, FM 2002, 'Long-term treatment with sulindac in familial adenomatous polyposis: A prospective cohort study', Gastroenterology, vol. 122, no. 3, pp. 641-645.
CruzCorrea, Marcia ; Hylind, Linda M. ; Romans, Katharine E. ; Booker, Susan V. ; Giardiello, Francis M. / Long-term treatment with sulindac in familial adenomatous polyposis : A prospective cohort study. In: Gastroenterology. 2002 ; Vol. 122, No. 3. pp. 641-645.
@article{8b562d9558184a22bc14a5dae60fa591,
title = "Long-term treatment with sulindac in familial adenomatous polyposis: A prospective cohort study",
abstract = "Background and Aims: Management of patients with familial adenomatous polyposis (FAP) can consist of colectomy with ileorectal anastomosis (IRA). Sulindac, a nonsteroidal anti-inflammatory drug, causes regression of colorectal adenomas in the retained rectal segment of FAP patients, although long-term use of this therapy has not been studied. We evaluated the long-term effectiveness and toxicity of sulindac in attempting to maintain retained rectal segments free of adenomas. Methods: Twelve FAP patients (5 women), mean age 37.1 years, with IRA received sulindac (mean dosage, 158 mg/day) for a mean period of 63.4 ± 31.3 months (range, 14-98 months). Number, size, and histologic grade of polyps, side effects, and medication compliance were assessed every 4 months. Results: Seven of 12 patients (58{\%}) remained in the study (6 of these polyp-free) for a mean of 76.9 ± 27.5 months. Five of 12 patients (42{\%}) withdrew from the trial after a mean follow-up period of 44 ± 28 months (range, 14-89 months). A significant regression of polyp number was observed in all patients at 12 months (P = 0.039) and at a mean of 63.4 ± 31.3 months (P = 0.006). Prevention of recurrence of higher-grade adenomas (tubulovillous, villous adenomas) was also observed (P = 0.004). At 35 months of follow-up, 1 patient developed stage III cancer in the rectal stump. The most common side effect was rectal mucosal erosions in 6 patients. Conclusions: Long-term use of sulindac seems to be effective in reducing polyp number and preventing recurrence of higher-grade adenomas in the retained rectal segment of most FAP patients. Erosions at the IRA site can preclude adequate dose maintenance.",
author = "Marcia CruzCorrea and Hylind, {Linda M.} and Romans, {Katharine E.} and Booker, {Susan V.} and Giardiello, {Francis M}",
year = "2002",
language = "English (US)",
volume = "122",
pages = "641--645",
journal = "Gastroenterology",
issn = "0016-5085",
publisher = "W.B. Saunders Ltd",
number = "3",

}

TY - JOUR

T1 - Long-term treatment with sulindac in familial adenomatous polyposis

T2 - A prospective cohort study

AU - CruzCorrea, Marcia

AU - Hylind, Linda M.

AU - Romans, Katharine E.

AU - Booker, Susan V.

AU - Giardiello, Francis M

PY - 2002

Y1 - 2002

N2 - Background and Aims: Management of patients with familial adenomatous polyposis (FAP) can consist of colectomy with ileorectal anastomosis (IRA). Sulindac, a nonsteroidal anti-inflammatory drug, causes regression of colorectal adenomas in the retained rectal segment of FAP patients, although long-term use of this therapy has not been studied. We evaluated the long-term effectiveness and toxicity of sulindac in attempting to maintain retained rectal segments free of adenomas. Methods: Twelve FAP patients (5 women), mean age 37.1 years, with IRA received sulindac (mean dosage, 158 mg/day) for a mean period of 63.4 ± 31.3 months (range, 14-98 months). Number, size, and histologic grade of polyps, side effects, and medication compliance were assessed every 4 months. Results: Seven of 12 patients (58%) remained in the study (6 of these polyp-free) for a mean of 76.9 ± 27.5 months. Five of 12 patients (42%) withdrew from the trial after a mean follow-up period of 44 ± 28 months (range, 14-89 months). A significant regression of polyp number was observed in all patients at 12 months (P = 0.039) and at a mean of 63.4 ± 31.3 months (P = 0.006). Prevention of recurrence of higher-grade adenomas (tubulovillous, villous adenomas) was also observed (P = 0.004). At 35 months of follow-up, 1 patient developed stage III cancer in the rectal stump. The most common side effect was rectal mucosal erosions in 6 patients. Conclusions: Long-term use of sulindac seems to be effective in reducing polyp number and preventing recurrence of higher-grade adenomas in the retained rectal segment of most FAP patients. Erosions at the IRA site can preclude adequate dose maintenance.

AB - Background and Aims: Management of patients with familial adenomatous polyposis (FAP) can consist of colectomy with ileorectal anastomosis (IRA). Sulindac, a nonsteroidal anti-inflammatory drug, causes regression of colorectal adenomas in the retained rectal segment of FAP patients, although long-term use of this therapy has not been studied. We evaluated the long-term effectiveness and toxicity of sulindac in attempting to maintain retained rectal segments free of adenomas. Methods: Twelve FAP patients (5 women), mean age 37.1 years, with IRA received sulindac (mean dosage, 158 mg/day) for a mean period of 63.4 ± 31.3 months (range, 14-98 months). Number, size, and histologic grade of polyps, side effects, and medication compliance were assessed every 4 months. Results: Seven of 12 patients (58%) remained in the study (6 of these polyp-free) for a mean of 76.9 ± 27.5 months. Five of 12 patients (42%) withdrew from the trial after a mean follow-up period of 44 ± 28 months (range, 14-89 months). A significant regression of polyp number was observed in all patients at 12 months (P = 0.039) and at a mean of 63.4 ± 31.3 months (P = 0.006). Prevention of recurrence of higher-grade adenomas (tubulovillous, villous adenomas) was also observed (P = 0.004). At 35 months of follow-up, 1 patient developed stage III cancer in the rectal stump. The most common side effect was rectal mucosal erosions in 6 patients. Conclusions: Long-term use of sulindac seems to be effective in reducing polyp number and preventing recurrence of higher-grade adenomas in the retained rectal segment of most FAP patients. Erosions at the IRA site can preclude adequate dose maintenance.

UR - http://www.scopus.com/inward/record.url?scp=0036177847&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036177847&partnerID=8YFLogxK

M3 - Article

VL - 122

SP - 641

EP - 645

JO - Gastroenterology

JF - Gastroenterology

SN - 0016-5085

IS - 3

ER -