High-Dose Urso Associated with Increased Colon Cancer Incidence

Many clinicians start patients with coexistent primary sclerosing cholangitis (PSC) and ulcerative colitis (UC) on a low dose (13–15 mg/kg/day) of ursodeoxycholic acid (urso) because previous studies have suggested that it might lower their risk for colorectal cancer. Now, researchers have explored whether high-dose urso provides such a benefit.

In a nested cohort study of 56 patients within a prior randomized controlled trial of high-dose urso (28–30 mg/kg/day) for the treatment of PSC, investigators examined results of surveillance colonoscopies for colorectal neoplasia.

After a mean of 4 years of drug use and follow-up, 9 (36.0%) of 25 patients in the urso arm developed neoplasia in the colon (1 cancer, 1 high-grade dysplasia, and 7 low-gr…