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The efficacy and safety of non‐steroidal anti‐inflammatory drugs in preventing the recurrence of colorectal adenoma: a meta‐analysis and systematic review of randomized trials
Author(s) -
Wang Y.,
Zhang F.C.,
Wang Y.J.
Publication year - 2015
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.12838
Subject(s) - medicine , placebo , colorectal adenoma , meta analysis , randomized controlled trial , confidence interval , relative risk , adenoma , colorectal cancer , pathology , cancer , alternative medicine
Abstract Aim We report a meta‐analysis and systematic review of randomized trials assessing the impact of non‐steroidal anti‐inflammatory drugs ( NSAID s) in preventing recurrence of colorectal adenoma. Method PubMed/Medicine, EMBASE and the Cochrane Central Register of Controlled Trials databases were searched for relevant randomized double‐blind placebo‐controlled trials published before March 2014. Two authors independently assessed study quality and extracted data. stata software was used to investigate heterogeneity between studies, and analysis was performed using a fixed‐effects model to calculate and merge data. Results Nine studies, with 8521 subjects, were included. Results were categorized by the duration of follow‐up. The relative risks of any recurrence of adenoma in patients receiving NSAID s compared with the placebo group were 0.68 [95% confidence interval ( CI ) 0.63–0.73, P = 0.001] for patients with a 1‐year follow‐up, 0.75 (95% CI 0.68–0.83, P = 0.246) with 3 years and 1.43 (95% CI 1.14–1.79, P = 0.127) with follow‐up of over 3 years. Using pooled risk ratios, NSAID s were associated with a significant decrease in adenoma recurrence at 1 and 3 years, although this association was lost beyond 3 years of follow‐up. For secondary prevention of advanced adenomas, the pooled risk ratios (compared with placebo) were 0.51 (95% CI 0.43–0.60, P = 0.026) after 1 year, 0.61 (95% CI 0.50–0.76, P = 0.887) at 3 years and 1.39 (95% CI 0.89–2.16, P = 0.829) after 3 years. Conclusion The meta‐analysis indicated that oral NSAID s may be effective in the early prevention of secondary occurrence of adenomas.