Ursodeoxycholic acid for chemioprevention in patients with ulcerative cholitis at risk of developing cancer

Patients and Methods: Sixteen patients (10 men, 6 women, median age 44 years, range 27-54 years) with histologically confirmed extensive UC (> 2/3 of colon involved) in the colon and rectum, underwent histopathological scoring for dysplasia, and colonscopic surveillance performed at 6, 12, 18, and 24 months. At each colonscopy two biopsies were sampled from each of nine predetermined segments of the colon and rectum. The grading of dysplasia (GD) was classified as 0 (no dysplasia, or probably negative), 1 (probably positive), 2 (low-grade dysplasia), 3 (high-grade dysplasia), 4 (dysplasia associated lesion or mass). All patients underwent UDCA therapy (500 mg daily), and the duration of the treatment was two years. The exclusion criteria were pregnancy or childbearing, history of drugs abuse, or allergy to UDCA. Informed consent was obtained from all participants in accordance with institutional review board approval. Results: Pre-treatment GD was 1.370.96, while the two-year GD was 1.190.83 (p\ubc0.57). Two patients underwent endoscopic excision of a sessile dysplastic polyp in the sigmoid colon (pre-treatment GD: 2 and 3, respectively). No colorectal cancer was detected in the colonscopy specimens during follow-up, and no patients underwent surgery. Conclusions: Evidence suggests, but does not prove, that UDCA therapy significantly decreased the risk of developing colorectal cancer in patients with UC, reducing theGD. Further studies are needed to fully define the role ofUDCA in the chemoprevention of colonic inflammatory bowel disease