November 8, 2002
Data presented last month at the 10th United European Gastroenterology Week shows encouraging results
More evidence that taking your medication does a body good: Results of a recent study from the UK suggests that Inflammatory Bowel Disease patients (IBD) who take their 5-ASA/mesalazine medicine regularly may lower the risk of developing colorectal cancer (CRC).
Of the million-plus people across Europe who have IBD as either Ulcerative Colitis or Crohn's Disease -- one in six will die from CRC, but recent advances in understanding the available treatment could significantly reduce this figure.
"We are extremely encouraged by the new data that shows a positive correlation between long-term use of 5-ASA/mesalazine for maintenance of remission and a reduction in the risk of developing CRC in patients with IBD,' said Prof. Michael Kamm. Kamm is professor and chairman of Gastroenterology Medicine at St. Mark's Hospital in London.
Mounting evidence touts benefits of 5-ASAs
The most recent meta-analysis to look at colorectal cancer and 5-ASA published in GUT, 2001 examined the effects of 5-ASA on cancers of the colon and the rectum.
Researchers evaluated data published for almost 2,000 men and women aged 15 and over for several years. They tracked the development of either colon or rectal cancer for the participants, who were cancer-free when they entered the study, and recorded participants' compliance with various medications and doctor's visits.
The results showed that those who complied fully with their 5-ASA treatment regiment were least likely to develop colon cancer over the study period. In fact those who complied completely with their 5-ASA treatment schedule had the same rate of incidence for CRC as the general public which is approximately 3 percent.
Investigator Dr Jayne Eaden, consultant in Gastroenterology at the Walsgrave Hospital, Coventry, UK, who in 2000 in Alimentary Pharmacology & Therapeutics reported on a range of treatments studied, concluding: "5-ASA was the only treatment associated with a statistically significant reduction in the risk of developing cancer."
The reduction in risk can be as great as 81 per cent or higher, claims Dr. Eaden, but such marked improvement goes hand in hand with improved levels of patient compliance - taking the right doses, in the right manner, at the right time, for the full prescribed course of treatment.
According to Dr. Eaden, the greatest degree of protection from CRC comes to patients fully compliant with their
5 ASA/mesalazine treatment regime; who follow up regularly with their health care provider; and who undergo a colonoscopy - all aspects substantially under the control of the patient. Some GPs and hospitals are leading the way forward through empowering their patients, effectively giving them the knowledge to make informed decisions, breaking down some of the traditional barriers between doctor and patient.
There's a long way to go. Studies indicate that compliance can be as low as 40 per cent, with six out of ten patients deciding to discontinue treatment, or to take the drugs as and when they prefer, rather than as advised.
Can the effect of mesalazine be explained?
5-ASA/mesalazine is the preferred treatment to induce remission and to prevent relapses in IBD. The long-term added benefit of this treatment with the reduced incidence of CRC is promising.
The anti-inflammatory 5-ASA family of drugs contains mesalazine. Pure mesalazine products are provided in various formulations, or sustained release which requires pH levels between 6-7 to dissolve. Also inert carriers of mesalazine and sulphapyridine carrier (sulphasalazine), where the sulpha moiety may cause a high number of side-effects.
Mesalazine has been shown to significantly enhance the sufferers' quality of life in both disease specific and general measures, and is used to induce remission in IBD and to extend periods of remission - and with few side-effects.
'The data is very compelling, because not only can mesalazine prevent bothersome relapses but it may be able to significantly reduce the risk of developing CRC from IBD,' said Dr. Anne-Marie Grauholt, medical affairs director for Ferring, one of the makers of mesaiazine.
Although the mechanism by which mesalazine may inhibit cancer is unclear, researchers suspect that it may help protect against colon cancer by restoring, at least partially, the natural cell regeneration which is absent in malignant cancerous tumours.
A Unique Link to Aspirin
Researchers think that the drug may help to inhibit their growth and development, increase the cell turnover in malignant cells and to diminish risk of mutations.
Much like its sister product, aspirin, mesalazine has similar molecular targets interfering with inflammation, proliferation and/or apoptosis as aspirin, said Prof. Hubert Allgayer of the Academic Teaching Hospital of the University of Heidelberg, Germany.
In addition, there is close molecular similarity of mesalazine with aspirin differing only in its structure by the presence of an aminogroup at position 5.
Notes to Editors
Ferring Pharmaceuticals is one of the global leaders in developing treatments for IBD and their product PENTASA (mesalazine) provides relief to patients around the world, suffering from IBD, e.g. Ulcerative Colitis and Crohns Disease.
The company is making strides to create research alliances world-wide to gain access to new research initiatives and additional promising compounds. More than 250 physicians and researchers from 20 countries participated in the Ferring sponsored international symposia last week at the 10th United European Gastroenterology Week in Geneva, Switzerland.
Ferring is a research driven, specialty biopharmaceutical group active in global markets. The company identifies, develops and markets innovative products in the areas of endocrinology, gastroenterology, gynecology, infertility and urology.
In recent years Ferring has expanded beyond its traditional European base and now has operating subsidiaries in over 40 countries.
To learn more about Ferring or our products please visit us at www.Ferring.com
For more information, please contact:
Ferring International Center
Telephone: + 45 28 78 72 09