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UDCA may reduce recurrence of high-grade colorectal adenomas

A study, led by David S. Alberts, of the Arizona Cancer Center at Tucson, found that Ursodeoxycholic Acid ( UDCA ) treatment is associated with a 39% relative reduction in the risk of recurrence of high-grade colorectal adenomas.

Secondary bile acids in stool, particularly deoxycholic acid ( DCA ), have been implicated in the pathogenesis of colorectal cancer.

Preclinical research and early-phase trials have indicated that treatment with UDCA, which suppresses many of the biological pathways turned on by DCA, is associated with a reduced incidence of colorectal neoplasia.

David S. Alberts, of the Arizona Cancer Center in Tucson, and colleagues conducted a phase III double-blind, placebo-controlled trial of UDCA in 1,285 patients who had undergone removal of a colorectal adenoma.
The participants were randomly assigned to received UDCA ( 8–10 mg/kg of body weight; 661 participants ) or a placebo ( 624 participants ) for 3 years or until a follow-up colonoscopy.

UDCA treatment was associated with a 12% reduction in adenoma recurrence compared with placebo ( 43.9% of the placebo group versus 41.0% of the UDCA group had at least one recurrent adenoma ), but this result was not statistically significant.

However, UDCA treatment was associated with a statistically significant 39% reduction in the recurrence of adenomas with high-grade dysplasia ( 8.7% in the placebo group versus 5.5% in the UDCA group ).

" Because severely dysplastic lesions have a greater potential for progression to invasive colorectal carcinoma than lesions with less dysplasia, this finding warrants further investigation in future chemoprevention trials of UDCA in this population, " the authors write.

Source: Journal of National Cancer Institute, 2005


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