{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T11:32:02Z","timestamp":1791199922491,"version":"4.2.0"},"reference-count":40,"publisher":"BMJ","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"accepted":{"date-parts":[[2009,12,1]]},"published-print":{"date-parts":[[2010,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The omega-3 polyunsaturated fatty acid eicosapentaenoic acid (EPA) has anticolorectal cancer activity in vitro and in preclinical models. The present study tested whether a novel, enteric-coated formulation of EPA, as the free fatty acid (EPA-FFA), has chemopreventative efficacy in patients with familial adenomatous polyposis (FAP), in a randomised, double-blind, placebo-controlled trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients undergoing endoscopic surveillance of their retained rectum postcolectomy were randomised to EPA-FFA (SLA Pharma) 2\u2005g daily or placebo for 6\u2005months. The number and size of polyps in an area of mucosa defined by a tattoo were determined before and after intervention. Global rectal polyp burden was scored (\u22121, 0, +1) by examination of video endoscopy records. Mucosal fatty acid content was measured by gas chromatography\u2013mass spectrometry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>55 patients with FAP were evaluated by an intention-to-treat analysis (EPA-FFA 28, placebo 27). Treatment with EPA-FFA for 6\u2005months was associated with a mean 22.4% (95% CI 5.1% to 39.6%) reduction in polyp number (p=0.012) and a 29.8% (3.6% to 56.1%) decrease in the sum of polyp diameters (p=0.027). Global polyp burden worsened over 6\u2005months in the placebo group (\u22120.34) unlike the EPA-FFA group (+0.09, difference 0.42 (0.10\u20130.75), p=0.011). EPA-FFA treatment led to a mean 2.6-fold increase in mucosal EPA levels (p=0.018 compared with placebo). EPA-FFA was well tolerated with an incidence of adverse events similar to placebo.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>EPA-FFA has chemopreventative efficacy in FAP, to a degree similar to that previously observed with selective cyclo-oxygenase-2 inhibitors. EPA holds promise as a colorectal cancer chemoprevention agent with a favourable safety profile.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial number<\/jats:title>\n                    <jats:p>NCT00510692.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/gut.2009.200642","type":"journal-article","created":{"date-parts":[[2010,3,26]],"date-time":"2010-03-26T23:09:39Z","timestamp":1269644979000},"page":"918-925","source":"Crossref","is-referenced-by-count":217,"title":["Eicosapentaenoic acid reduces rectal polyp number and size in familial adenomatous polyposis"],"prefix":"10.1136","volume":"59","author":[{"given":"Nicholas J","family":"West","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan K","family":"Clark","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin K S","family":"Phillips","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M","family":"Hutchinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger J","family":"Leicester","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Belluzzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A","family":"Hull","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2010,3,26]]},"reference":[{"key":"2025121305432113000_59.7.918.1","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1615\/JEnvironPatholToxicolOncol.v28.i1.50","article-title":"Revolutionary advances in the diagnosis and treatment of familial adenomatous polyposis","volume":"28","author":"Edlich","year":"2009","journal-title":"J Environ Pathol Toxicol Oncol"},{"key":"2025121305432113000_59.7.918.2","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2007.136127"},{"key":"2025121305432113000_59.7.918.3","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.104"},{"key":"2025121305432113000_59.7.918.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199305063281805"},{"key":"2025121305432113000_59.7.918.5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200006293422603"},{"key":"2025121305432113000_59.7.918.6","first-page":"4756","article-title":"A randomized, double-blind, placebo-controlled trial of the effects of rofecoxib, a selective cyclooxygenase-2 inhibitor, on rectal polyps in familial adenomatous polyposis patients","volume":"9","author":"Higuchi","year":"2003","journal-title":"Clin Cancer Res"},{"key":"2025121305432113000_59.7.918.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2009.01.014"},{"key":"2025121305432113000_59.7.918.8","doi-asserted-by":"publisher","DOI":"10.1002\/biof.42"},{"key":"2025121305432113000_59.7.918.9","doi-asserted-by":"publisher","DOI":"10.2174\/092986707782793934"},{"key":"2025121305432113000_59.7.918.10","doi-asserted-by":"publisher","DOI":"10.1001\/jama.295.4.403"},{"key":"2025121305432113000_59.7.918.11","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.24.3130"},{"key":"2025121305432113000_59.7.918.12","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-291X(88)80718-6"},{"issue":"Suppl 1","key":"2025121305432113000_59.7.918.13","first-page":"A761","article-title":"Highly purified eicosapentaenoic acid acts as a potent COX-2 inhibitor and represses polyp formation in APC MIN\/+ mice","volume":"136","author":"Fini","year":"2009","journal-title":"Gastroenterology"},{"key":"2025121305432113000_59.7.918.14","doi-asserted-by":"publisher","DOI":"10.1093\/carcin\/18.10.1905"},{"key":"2025121305432113000_59.7.918.15","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1093\/jn\/130.5.1153","article-title":"Antagonism of arachidonic acid is linked to the antitumorigenic effect of dietary eicosapentaenoic acid in Apc\n               Min\/+ mice","volume":"130","author":"Hansen Petrik","year":"2000","journal-title":"J Nutr"},{"key":"2025121305432113000_59.7.918.16","first-page":"4790","article-title":"Effect of dietary eicosapentaenoic acid on azoxymethane-induced colon carcinogenesis in rats","volume":"48","author":"Minoura","year":"1988","journal-title":"Cancer Res"},{"key":"2025121305432113000_59.7.918.17","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-006-0240-4"},{"key":"2025121305432113000_59.7.918.18","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199606133342401"},{"key":"2025121305432113000_59.7.918.19","doi-asserted-by":"publisher","DOI":"10.1136\/gut.32.10.1151"},{"key":"2025121305432113000_59.7.918.20","doi-asserted-by":"publisher","DOI":"10.1016\/S0021-9673(03)00217-6"},{"key":"2025121305432113000_59.7.918.21","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa061355"},{"key":"2025121305432113000_59.7.918.22","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa061652"},{"key":"2025121305432113000_59.7.918.23","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2006.08.079"},{"key":"2025121305432113000_59.7.918.24","doi-asserted-by":"publisher","DOI":"10.1136\/gut.50.6.857"},{"key":"2025121305432113000_59.7.918.25","doi-asserted-by":"crossref","first-page":"1709","DOI":"10.1016\/0016-5085(94)90811-7","article-title":"Effects of different doses of fish oil on rectal cell proliferation in patients with sporadic colonic adenomas","volume":"107","author":"Anti","year":"1994","journal-title":"Gastroenterology"},{"key":"2025121305432113000_59.7.918.26","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.R100062200"},{"issue":"Suppl","key":"2025121305432113000_59.7.918.27","doi-asserted-by":"crossref","first-page":"1467S","DOI":"10.1093\/ajcn\/83.6.1467S","article-title":"Distribution, interconversion, and dose response of n-3 fatty acids in humans","volume":"83","author":"Arterburn","year":"2006","journal-title":"Am J Clin Nutr"},{"key":"2025121305432113000_59.7.918.28","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1093\/ajcn\/77.3.565","article-title":"Effects of beef- and fish-based diets on the kinetics of n-3 fatty acid metabolism in human subjects","volume":"77","author":"Pawlosky","year":"2003","journal-title":"Am J Clin Nutr"},{"key":"2025121305432113000_59.7.918.29","doi-asserted-by":"publisher","DOI":"10.1097\/MOG.0b013e32801145d7"},{"key":"2025121305432113000_59.7.918.30","doi-asserted-by":"publisher","DOI":"10.1093\/carcin\/24.3.385"},{"key":"2025121305432113000_59.7.918.31","first-page":"1386","article-title":"Suppression of tumour cell growth both in nude mice and in culture by n-3 polyunsaturated fatty acids: mediation through cyclooxygenase-independent pathways","volume":"61","author":"Boudreau","year":"2001","journal-title":"Cancer Res"},{"key":"2025121305432113000_59.7.918.32","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.M703169200"},{"key":"2025121305432113000_59.7.918.33","doi-asserted-by":"publisher","DOI":"10.1194\/jlr.M300455-JLR200"},{"key":"2025121305432113000_59.7.918.34","doi-asserted-by":"publisher","DOI":"10.1093\/carcin\/bgm256"},{"key":"2025121305432113000_59.7.918.35","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(99)07072-5"},{"key":"2025121305432113000_59.7.918.36","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.94.7.1553"},{"key":"2025121305432113000_59.7.918.37","doi-asserted-by":"publisher","DOI":"10.1158\/1940-6207.CAPR-08-0206"},{"key":"2025121305432113000_59.7.918.38","doi-asserted-by":"publisher","DOI":"10.2165\/00002018-200932040-00007"},{"key":"2025121305432113000_59.7.918.39","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.02.084"},{"key":"2025121305432113000_59.7.918.40","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(81)91436-7"}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.2009.200642","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T13:43:31Z","timestamp":1765633411000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.2009.200642"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,3,26]]},"references-count":40,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2010,6,25]]},"published-print":{"date-parts":[[2010,7]]}},"alternative-id":["10.1136\/gut.2009.200642"],"URL":"https:\/\/doi.org\/10.1136\/gut.2009.200642","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"value":"0017-5749","type":"print"},{"value":"1468-3288","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,3,26]]}}}