NSAID EFFECT ON SPORADIC COLON POLYPS

In this study, our objective was to determine whether 6 months of open -label therapy with sulindac 400 mg/daily or piroxicam 20 mg/daily pro mote regression of adenomatous colonic polyps left in situ. Left-sided colonic polyps (size 3-12 mm) detected at colonoscopy were measured a nd left without being biopsied. The bowel wall opposite to the polyps was marked with India ink submucosally. Patients were assigned to drug therapy, and compliance was determined by pill count. Polyps were mea sured during sigmoidoscopy after 3 and 6 months of treatment; polyps w ere removed at the 6-month examination. Examiners were not blinded to drug therapy or previous polyp measurements. Seven patients completed 6 months of therapy (five sulindac and two piroxicam). Two additional patients treated with piroxicam were withdrawn secondary to adverse ev ents (bleeding gastric ulcer and rash). In one patient treated with su lindac, a 6-mm polyp disappeared, and two other polyps seemed to regre ss partially. One polyp regressed partially in a piroxicam-treated pat ient. All other polyps remained unchanged. Conclusions: We did not obs erve dramatic regression of sporadic colon adenomatous polyps to eithe r sulindac or piroxicam after 6 months of therapy in this small uncont rolled pilot study.