Findings from a study published in The BMJ have shown that for most patients, nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs) are more effective than aspirin or nutritional supplements in preventing the growth of advanced adenomas. 

Researchers from the Mayo Clinic and scientists from across the country aimed to evaluate the comparative efficacy of NSAIDs, aspirin, and supplements in preventing the recurrence of advanced neoplasia after polyp removal. They performed a meta-analysis of data from 15 randomized controlled trials that included 12,234 patients. The analyzed studies looked at low-dose and high-dose aspirin, calcium, vitamin D, folic acid, and compared them as single therapy or in different combinations. 

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The team, led by M. Hassan Murad, MD, reported that nonaspirin NSAIDs (eg, ibuprofen) were ranked best compared to all the other studied treatments for preventing the recurrence of adenomatous polyps within 3-5 years after initial polyp removal. Due to health risks associated with nonaspirin NSAIDs, these drugs may not be the ideal choice for all patients. 

The data on aspirin showed nearly comparable results carrying less additional risk. Although low-dose aspirin was second best in its preventive effects, “the excess benefit over risk might therefore be favorable for many patients,” explained Dr. Murad.

The authors generally cautioned that treatment for each patient should be individualized and both patients and clinicians should discuss the various risks vs. benefits associated with any medication. 

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