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Peroral sustained-release indomethacin treatment for rectal adenomas in familial adenomatous polyposis: a pilot study.

BACKGROUND/AIMS
The efficacy of peroral sustained-release indomethacin on rectal adenomas in colectomized patients with familial adenomatous polyposis and its toxicity were evaluated preliminarily.


METHODOLOGY
A total of seven colectomized patients with familial adenomatous polyposis were treated with peroral sustained-release indomethacin at the usual clinical doses. The numbers of rectal polyps before and after treatment and approximately one year after cessation of treatment were counted using a flexible colonoscope and compared.


RESULTS
After treatment, reductions of rectal polyp size were observed in all patients. Numbers of the rectal polyps also decreased significantly after treatment (median, 1; range, 0 to 30) compared with those before treatment (median, 19; range, 4 to 78) (P = 0.023). However, Grade 4 anemia due to lower intestinal ulcers occurred in two patients. Moreover, one year after termination of the treatment, increase in the size and number of rectal polyps was observed in six patients.


CONCLUSIONS
Because of incomplete efficacy and severe toxicity, general use of this treatment for familial adenomatous polyposis patients must be deemed inappropriate.