IngentaConnect Histamine receptor antagonists and incident colorectal adenomas

Authors: ROBERTSON, D. J.¹; BURKE, C. A.²; SCHWENDER, B. J.³; WARGOVICH, M. J.⁴; GREENBERG, E. R.⁵; SANDLER, R. S.⁶; AHNEN, D. J.⁷; ROTHSTEIN, R.³; MOTT, L. A.⁸; BARON, J. A.⁵

Source: Alimentary Pharmacology & Therapeutics, Volume 22, Number 2, July 2005 , pp. 123-128(6)

Publisher: Blackwell Publishing

Abstract:

Summary Background:

Prior studies suggest that histamines may modulate the development of colorectal neoplasia. Aim:

To assess whether histamine receptor antagonist use was associated with adenoma formation. Methods:

Patients (n = 2366) were drawn from three adenoma chemoprevention trials. All underwent baseline colonoscopy with removal of adenoma(s) and were deemed free of remaining lesions; they were followed with surveillance colonoscopy. Medication use was assessed by questionnaire. Adjusted risk ratios for adenoma formation related to histamine receptor antagonist use (histamine H1 and H2 receptor, H1RA and H2RA) were determined using log linear models. Results:

In pooled analyses, H1RA exposure was not associated with subsequent adenoma risk (RR = 1.10; 95% CI 0.97–1.25) or multiple adenoma formation (RR = 0.85; 95% CI 0.67–1.07). H2RA use also was not associated with adenoma (RR = 0.90; 95% CI 0.77–1.06), or multiple adenoma (RR = 0.77; 95% CI 0.57–1.04) in the pooled analyses, but H2RA users in the first trial had a decreased risk of adenoma (RR = 0.70; 95% CI 0.48–1.03) and multiple adenoma (RR = 0.31; 95% CI 0.12–0.79). Conclusion:

H2RA use was associated with reduced risk for adenoma in one trial, but not in the pooled analyses. Further study would be warranted before undertaking randomized trials of H2RAs for adenoma chemoprevention.

Document Type: Research article

DOI: 10.1111/j.1365-2036.2005.02529.x

Affiliations: 1: VA Medical Center, White River Junction, VT and Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA 2: Department of Gastroenterology, Cleveland Clinic Foundation; Cleveland, OH, USA 3: Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA 4: Department of Pathology and Microbiology, University of South Carolina, School of Medicine and South Carolina Cancer Center, Columbia, SC, USA 5: Departments of Medicine and Community and Family Medicine and the Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA 6: Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA 7: VA Medical Center and Department of Medicine, University of Colorado School of Medicine, Denver CO, USA 8: Department of Community and Family Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA