Effect of sulindac on sporadic colonic polyps

Area of Science:

• Gastroenterology
• Oncology
• Pharmacology

Background:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) like sulindac have shown polyp regression in familial adenomatous polyposis.
• Sporadic colonic polyps are common and can progress to cancer.

Purpose of the Study:

• To investigate if sulindac can cause regression of sporadic colonic polyps in a double-blinded, placebo-controlled study.

Main Methods:

• 162 asymptomatic patients with polyps < 1 cm were screened.
• 22 patients received sulindac (150 mg twice daily) and 22 received placebo for 4 months.
• Colonoscopy was performed post-treatment to assess polyp regression and size.

Main Results:

• No statistically significant difference in polyp regression or size between sulindac and placebo groups.
• Sulindac treatment showed only a 0.8% chance of achieving 50% polyp regression.
• Adverse events led to four patients discontinuing sulindac.

Conclusions:

• Four months of sulindac treatment does not clinically regress sporadic colonic polyps.
• The biological response of sporadic polyps to sulindac differs from that of familial adenomatous polyposis polyps.
• A small effect of sulindac on sporadic polyps may not have been detected due to study size.