מתוך medicontext.co.il
By Anthony J. Brown, MD
WESTPORT, CT (Reuters Health) – Histamine 2 (H2) receptor antagonist use is linked with a decreased risk of colorectal polyp recurrence after colonoscopic excision, according to study findings presented on Monday at the 66th Annual Scientific Meeting of the American College of Gastroenterology.
Dr. Carol A. Burke, from the Cleveland Clinic Foundation in Ohio, and colleagues assessed the polyp recurrence rates of 750 subjects who participated in an adenoma chemoprevention study. After having at least one polyp excised and confirmation of no further polyps, the subjects underwent colonoscopy 1 and 4 years later.
The initial objective was to determine whether use of various vitamins reduced the polyp recurrence rate, the researchers note. The results indicated that vitamin use had no effect on polyp recurrence.
After these results were published, findings from animal studies were released which suggested that H1 and H2 antagonists may inhibit adenoma formation. This motivated Dr. Burke's team to reanalyze their data with respect to H1 and H2 antagonist use. The researchers identified 133 and 118 subjects who used H1 and H2 antagonists, respectively, at some point during the study.
Subjects who used H2 antagonists during the first year had a 38% reduced risk of developing a recurrent adenoma. Frequent H2 antagonist use was associated with a similar reduction in risk. H2 antagonist use at any time during the study yielded a 16% reduced risk. In contrast, H1 antagonist use was linked to an increased risk of adenoma recurrence.
"The current findings suggest that H2 antagonists are protective and should be studied further," Dr. Burke told Reuters Health. "The study was not initially designed to assess the protective effects of H1 or H2 antagonists," she pointed out.
"While H2 antagonist use was linked to a reduced risk of adenoma recurrence, the association was not statistically significant," Dr. Burke noted. "Perhaps if more patients had used H2 antagonists, the power of the study would have been great enough to demonstrate a significant difference," she added.
"The rates of colon cancer have been decreasing in the US…in the last 20 years," Dr. Burke stated. "We assumed that it was due to early screening and polypectomies, but this was also around the time when H2 blockers started being used," she noted. "Obviously, there is still a lot we don't know that requires further investigation."
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