A meta-analysis of the correlation between non-steroidal anti-inflammatory drugs and recurrent colorectal adenomatous polyps

Aim: The purpose of this study was to evaluate the effect of non-steroidal anti-inflammatory drugs (NSAIDs) on the recurrence risk of colorectal adenomas through a meta-analysis of published studies. Methods: A meta-analysis was performed to evaluate the effect of NSAIDs on the incidence rates of colorectal adenomatous polyps, using PubMed, Ovid, Elsevier, and other journal databases. Data were processed using Review Manager 5.3 and random errors were calculated using trial sequential analysis (TSA). Results: A total of 8 studies published between 2003 and 2014 were selected. In the data collected, the patients on long-term usage of low-dose NSAIDs were shown to have significantly lower risk of colorectal adenoma compared with those on placebos (RR=0.80, 95% CI=0.700.92), with relatively low random errors. Long-term usage of low-dose NSAIDs was also found to have inhibitory effects on advanced adenomas (RR=0.66, 95% CI=0.44-0.99), but with relatively high random errors. Besides, highdose NSAIDs were also shown to have inhibitory but inconsistent effects on adenomas and advanced adenomas (RR=0.66, 95% CI=0.59-0.72), and the withdrawal was associated with increased risks of the disease. Conclusion: These results suggest that low-dose NSAIDs have an inhibitory effect on recurrent adenomas, but the efficacy for late-stage adenomas remain inconclusive. The withdrawal of the drug might be associated with increased risks of the disease.