About this trial
Colorectal cancer (CRC) is a common malignancy of the digestive tract, which constitutes a major public health burden. Almost 90% of CRC cases progress from precursor adenomatous polyps through adenoma-carcinoma sequence. Endoscopic detection and removal of colorectal adenoma (CRA) could reduce the incidence and mortality risk of CRC, but the recurrence rate is still high. Therefore, chemoprevention is quite important, not only solve the urgent public health problem, but also be cost-effective.
In 2020, the investigators published a multicenter, randomized, double-blind, placebo-controlled clinical study (NCT02226185) in the Lancet Gastroenterology \& Hepatology. The result concluded that oral BBR for 2 years significantly reduced recurrence after endoscopic removal of CRA (RR 0.77, 95%CI 0.66-0.91; p=0.001). BBR also has a significant preventive effect on all polypoid lesions, including adenomas and serrated lesions (adjusted RR 0.78, 95%CI 0.66-0.91; p=0.002) . Does BBR still have a long-term protective effect on the recurrence of CRA after discontinuation? That's what the investigators concerned.
The present study is performed to observe and compare retrospectively the recurrence rate of CRAs in patients of the original BBR RCT study (NCT02226185) within 6 years after discontinuation of medication, including the overall recurrence rate of traditional adenomas within the first year, 1-3 years, 3-6 years, and the entire follow-up period of 6 years. The aim is to evaluate the long-term efficacy of BBR in preventing recurrence and carcinogenesis after endoscopic resection of CRAs.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
None
Disqualifiers
None
Trial population
We included 895 participants who completed the previous berberine intervention study (NCT02226185), including 432 participants in the BBR group and 463 participants in the placebo group.
Trial design
Cohort
Retrospective
Treatments tested in this trial
Berberine Hydrochloride
Drugpost-intervention of berberine
Placebo
DrugLooks the same as berberine
Treatment groups
Trial outcomes
Primary outcomes
The recurrence rates of traditional colorectal adenomas within the follow-up period of 6 years
The cumulative recurrence rate of CRAs within the entire follow-up period of 6 years. The recurrence rates of CRAs within the first year, 1-3 years, 3-6 years. The number, size and location of all adenomas are assessed.
Secondary outcomes
The incidence rates of hyperplastic polyps and serrated adenomas within 6 years after discontinuation of medication
The recurrence rates within the first year, 1-3 years, 3-6 years, and the entire follow-up period of 6 years.
Subgroup analyses
For patients with advanced CRA or high-risk adenomas (including advanced CRA and multiple adenomas≥3),the recurrence rates of CRAs and polyps are further evaluated.
Sponsors and contacts
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Shanghai Jiao Tong University School of Medicine
Lead sponsor
Seventh Medical Center of PLA Army General Hospital
Collaborator
Zhongshan Hospital Xiamen University
Collaborator
Nanfang Hospital, Southern Medical University
Collaborator
The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School
Collaborator
Tianjin Medical University General Hospital
Collaborator
the Tenth People's Hospital affiliated to Tongji University
Collaborator