Ursodeoxycholic acid in patients with ulcerative colitis and primary sclerosing cholangitis for prevention of colon cancer: a meta-analysis |
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Authors: | Imran Ashraf Abhishek Choudhary Murtaza Arif Michelle L. Matteson Hazem T. Hammad Srinivas R. Puli Matthew L. Bechtold |
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Affiliation: | Division of Gastroenterology and Hepatology, CE405, DC 043.00, University of Missouri Health Sciences Center, Five Hospital Drive, Columbia, MO 65212, USA. |
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Abstract: | Purpose/Aim Colon cancer risk is high in patients with ulcerative colitis (UC) and primary sclerosing cholangitis (PSC). Ursodeoxycholic acid has been shown to have some promise as a chemopreventive agent. A meta-analysis was performed to compare the efficacy of ursodeoxycholic acid in the prevention of colonic neoplasia in patients with UC and PSC. Methods Multiple databases were searched (January 2011). Studies examining the use of ursodeoxycholic acid vs. no ursodeoxycholic acid or placebo in adult patients with UC and PSC were included. Data were extracted in standard forms by two independent reviewers. Meta-analysis for the effect of ursodeoxycholic acid was performed by calculating pooled estimates of adenoma or colon cancer formation by odds ratio (OR) with random effects model. Heterogeneity was assessed by calculating the I 2 measure of inconsistency. RevMan 5 was utilized for statistical analysis. Results Four studies (n?=?281) met the inclusion criteria. The studies were of adequate quality. Ursodeoxycholic acid demonstrated no overall improvement in adenoma (OR 0.53; 95?% CI: 0.19?1.48, p?=?0.23) or colon cancer occurrence (OR 0.50; 95?% CI: 0.18?1.43, p?=?0.20) as compared to no ursodeoxycholic acid or placebo in patients with UC and PSC. Conclusion Ursodeoxycholic acid use in patients with UC and PSC does not appear to decrease the risk of adenomas or colon cancer. |
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