December 31, 2018
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Clopidogrel Reduces Colorectal Cancer Risk

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Inhibiting platelets with clopidogrel, either alone or in combination with low-dose aspirin, helped reduce risk for colorectal cancer, according to research published in Clinical Gastroenterology and Hepatology.

Francisco J. de Abajo, MD, PhD, MPH, of the clinical pharmacology unit at University Hospital “Principe de Asturias” in Madrid, Spain, and colleagues wrote that several studies have shown that low-dose aspirin has a protective effect against CRC. Although the exact mechanism of action is unknown, some have suggested that aspirin’s antiplatelet action could have something to do with it.

“It is unknown whether other antiplatelet drugs with a different mechanism of action (eg, clopidogrel), could share the chemoprotective effect of low-dose aspirin because few studies have been published so far to explore this hypothesis,” they wrote. “The primary aim of the present study was to test if clopidogrel shares a similar chemoprotective effect on CRC compared to low-dose aspirin.”

Researchers performed a nested case-control study of patients included in a primary care database from Spain. They analyzed data from 15,491 patients with CRC and matched them with 60,000 randomly selected control individuals based on age, sex and year to determine the effects of low-dose aspirin and clopidogrel on risk for CRC.

Investigators found that low-dose aspirin was associated with a reduced risk for CRC both overall (adjusted OR = 0.83; 95% CI, 0.78–0.89) and among patients receiving treatment for more than a year (aOR = 0.79; 95% CI, 0.73–0.8). A reduced risk was also observed among patients who used clopidogrel overall (aOR = 0.8; 95% CI, 0.69–0.93) and for more than a year (aOR = 0.65; 95% CI, 0.55–0.78). Dual anti-platelet therapy had the same effect as either drug taken alone.

“The results of the present study are compatible with a chemoprotective effect of clopidogrel against CRC, equivalent in magnitude to the one observed for low-dose aspirin,” de Abajo and colleagues wrote. “This finding indirectly supports the hypothesis that the chemoprotective effect of low-dose aspirin is mostly mediated through the permanent inactivation of platelet-COX-16.” – by Alex Young

Disclosures: De Abajo reports no relevant financial disclosures. Please see the full study for all other authors’ relevant financial disclosures.