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Drug Combo Stops Recurrent Colon Polyps

Researchers Say DFMO Plus Sulindac Less Toxic Than Chemotherapy

Celebrex Also Slashes Polyp Risks

A second study presented at the meeting showed that the popular painkiller Celebrex also slashes the risk of developing new precancerous colon growths -- even after people stop taking the drug.

But that research also showed that people taking Celebrex had more heart attacks, stroke, and other cardiovascular problems, particularly if they already had heart disease.

The researchers followed people who were involved in a study that was terminated early after Celebrex was linked to an increased risk of cardiovascular problems.

Participants took either 200 milligrams or 400 milligrams of Celebrex, or a placebo, twice a day, for three years. About 600 of them had a follow-up colonoscopy an average of one-and-one-half years after stopping the drug.

"At three years, there was about a 57% reduction in the presence of new advanced lesions in patients on the lower dose of Celebrex," says Monica Bertagnolli, MD, associate professor of surgery at the Brigham and Women's Hospital in Boston.

By an average of one-and-one-half years after discontinuing treatment, there was still a 41% reduction in advanced lesions among people on the lower dose of Celebrex, she tells WebMD

The higher dose was no more effective than the lower dose, Bertagnolli says.

Heart Safety of Celebrex Is a Concern

But 8.5% of patients on Celebrex had a heart attack, stroke, or other cardiovascular problem over the five-year period, Bertagnolli says.

"Almost any way you look at it, there is some cardiovascular risk associated with Celebrex. So we can't say the 200-milligram, twice-daily dose, is completely safe. We can say that neither dose should be used by patients with cardiovascular risk factors," Bertagnolli says.

So what about people at low risk of heart problems but high risk of colon cancer?

That's a muddy area, she says.

"For people at high risk, such as those who have had multiple, large adenomas removed, we can certainly say it is certainly effective," Bertagnolli tells WebMD.

The risks to the heart have to be weighed against the cancer-prevention benefits, she says.

Scott Lippman, MD, of the University of Texas M.D. Anderson Cancer Center in Houston and a participant at both presentations, tells WebMD: "These are two of the most important trials in cancer prevention research. They will take us into the future."

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