Effects of aspirin on risks of vascular events and cancer according to bodyweight and dose: analysis of individual patient data from randomised trials

Lancet
Peter M RothwellZiyah Mehta

Abstract

A one-dose-fits-all approach to use of aspirin has yielded only modest benefits in long-term prevention of cardiovascular events, possibly due to underdosing in patients of large body size and excess dosing in patients of small body size, which might also affect other outcomes. Using individual patient data, we analysed the modifying effects of bodyweight (10 kg bands) and height (10 cm bands) on the effects of low doses (≤100 mg) and higher doses (300-325 mg or ≥500 mg) of aspirin in randomised trials of aspirin in primary prevention of cardiovascular events. We stratified the findings by age, sex, and vascular risk factors, and validated them in trials of aspirin in secondary prevention of stroke. Additionally, we assessed whether any weight or height dependence was evident for the effect of aspirin on 20-year risk of colorectal cancer or any in-trial cancer. Among ten eligible trials of aspirin in primary prevention (including 117 279 participants), bodyweight varied four-fold and trial median weight ranged from 60·0 kg to 81·2 kg (p<0·0001). The ability of 75-100 mg aspirin to reduce cardiovascular events decreased with increasing weight (pinteraction=0·0072), with benefit seen in people weighing 50-69 kg (hazard ratio [HR]...Continue Reading

Citations

Aug 2, 2018·Nature Reviews. Cardiology·Gregory B Lim
Aug 22, 2018·Expert Opinion on Drug Safety·Antonis A ManolisAntonis S Manolis
Nov 13, 2018·Diabetes & Vascular Disease Research : Official Journal of the International Society of Diabetes and Vascular Disease·R A Ajjan
Oct 9, 2018·Expert Opinion on Pharmacotherapy·Beata FranczykJacek Rysz
Jan 3, 2019·European Heart Journal·Željko ReinerUlf Landmesser
Jan 19, 2019·The Annals of Pharmacotherapy·Erin Carson, Alice N Hemenway
Mar 7, 2019·JAMA Surgery·Tomaso Gnecchi-Ruscone, Domenico Restifo Pecorella
Apr 6, 2019·PLoS Genetics·Andy DahlNoah Zaitlen
Nov 6, 2018·Journal of the National Cancer Institute·Elizabeth L BarryJohn A Baron
Jul 16, 2019·Expert Review of Cardiovascular Therapy·Michael E PlazakStormi E Gale
Apr 2, 2019·Journal of Thrombosis and Haemostasis : JTH·Giovanna PetrucciBianca Rocca
Jul 30, 2019·Oxidative Medicine and Cellular Longevity·Patricia MarchioMaria D Mauricio
May 6, 2019·British Journal of Clinical Pharmacology·Simon B DimmittRobin E Ferner
Oct 27, 2018·International Journal of Molecular Sciences·Thomas SonnweberIvan Tancevski
Sep 1, 2019·Current Pharmaceutical Design·Alessandra VecchiéAldo Bonaventura
Sep 23, 2019·Internal and Emergency Medicine·Francesca Santilli, Paola Simeone
Jan 22, 2020·Journal of the American Heart Association·Joseph Pierre AboumsallemRudolf A de Boer
Dec 28, 2018·Neurology. Clinical Practice·Aravind GaneshBijoy K Menon
Sep 24, 2019·Circulation·Guillaume Marquis-GravelW Schuyler Jones
Dec 22, 2019·Diabetes Care·UNKNOWN American Diabetes Association
Jun 13, 2020·European Heart Journal·Thomas F LüscherFilippo Crea
Aug 19, 2020·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·Zlatko FrasMaciej Banach
Sep 24, 2019·Current Diabetes Reports·Mohammed E Al-SofianiRita R Kalyani
Aug 7, 2019·Expert Review of Cardiovascular Therapy·Davide CapodannoDominick J Angiolillo
Nov 15, 2019·Current Treatment Options in Cardiovascular Medicine·Nicholas D OsteraasSarah Song
Jan 17, 2020·Clinical Medicine : Journal of the Royal College of Physicians of London·John Burn
Apr 1, 2020·Circulation·Robyn L WoodsUNKNOWN ASPREE Investigator Group†
Aug 28, 2018·The New England Journal of Medicine·UNKNOWN ASCEND Study Collaborative GroupJane Armitage
May 3, 2019·The New England Journal of Medicine·John J McNeilUNKNOWN ASPREE Investigator Group
Mar 27, 2019·MMW Fortschritte der Medizin·Clemens KüpperLars Kellert
Sep 10, 2019·European Heart Journal·Francesco CosentinoUNKNOWN ESC Scientific Document Group

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Methods Mentioned

BETA
acetylation

Clinical Trials Mentioned

NCT00135226
NCT01038583
NCT00501059
NCT02697916

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