NEW YORK (Reuters Health) – In a small study of patients with familial adenomatous polyposis, the free fatty acid form of eicosapentaenoic acid (EPA-FFA) reduced both the size and number of polyps.
“EPA-FFA should be considered for chemoprevention in patients with familial adenomatous polyposis,” and its potential against sporadic colorectal neoplasia should also be investigated, the researchers say.
According to the report in the March 18th Online First issue of Gut by Dr. Mark Hull, from St. James’s University Hospital, Leeds, UK, and his colleagues, eicosapentaenoic acid has shown anti-colorectal cancer activity in vitro and in animals.
To investigate its effects in humans, the authors randomized 55 patients to receive either an enteric-coated formulation of EPA-FFA (2 g/day) or placebo for 6 months. All of the patients had ileorectal anastomoses from previous colectomies. This study focused on changes in the rectal remnant.
On intent-to-treat analysis, EPA-FFA reduced the number of polyps by an average of 22.4% compared to placebo (p = 0.012), and it reduced the sum of polyp diameters by 29.8% (p = 0.027). The global polyp burden worsened during the study in the placebo group but slightly improved in the EPA-FFA group, the authors report.
The treatment group had a 2.6-fold increase in mucosal EPA levels relative to the placebo group (p = 0.018).
EPA-FFA was comparable to placebo in terms of side effects and was well tolerated, the authors note.
“The selective cyclo-oxygenase-2 inhibitor celecoxib is licensed for use as an adjunct to endoscopic surveillance in familial adenomatous polyposis but has significant cardiovascular toxicity,” the researchers comment, adding, “The effect of EPA-FFA was similar in magnitude to that observed with celecoxib.”
The study was funded by SLA Pharma AG, which markets EPA-FFA capsules with the brand name ALFA.