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P577 Chemoprevention by mesalamine for colorectal cancer in UC-patients: a meta-analysis

F. van Geest*, S. Koene, T. Kalisvaart, D. Dieleman, D. van Kalkeren, M. Peppelenbosch

Erasmus MC, Gastroenterology, Rotterdam, Netherlands


Mesalamine, a 5-ASA preparation, is used in the treatment of mild ulcerative colitis (UC). It is known to have an anti-inflammatory effect. Multiple studies ascribed chemopreventive properties to this drug throughout the years. This meta-analysis aims to determine the chemopreventive effect of mesalamine (and other 5-ASA preparations) on colorectal neoplasia in patients with UC.


To determine whether the risk of developing colorectal cancer (CRC) is indeed lower in UC patients using mesalamine, a search for literature on this subject was performed on PubMed and Web of Science up to October 2014. To ensure suitability of the found publications, reviews, in vitro studies and studies on animal models were excluded.


After screening 274 publications, 27 were selected for full-text review. Among these, 8 trials were found eligible and were included in the meta-analysis. It showed an odds ratio of 0.36 (95% CI; 0.21-0.62). Moreover, two meta-analyses were conducted to determine the influence of potential bias. These showed only minor difference as compared to the first meta-analysis.


Mesalamine significantly reduces the risk of CRC in patients with UC and can be considered chemopreventive. The results of this study may be used as an indication for long-term prescription of mesalamine for a chemopreventive purpose.