Trending Clinical Topic: Aspirin

Ryan Syrek

Disclosures

January 03, 2020

Each week, we identify one top search term, speculate as to what caused its popularity, and provide an infographic on a related condition. If you have thoughts about what's trending and why, feel free to share them with us on Twitter or Facebook.

Positive news about reduced mortality and migraine treatment and concern about combined therapy for venous thromboembolism resulted in aspirin becoming this week's top trending clinical topic. New research found that older adults (> 65 years) who regularly took aspirin had a significant reduction in mortality from all causes and from cancer, compared with individuals who did not take aspirin. Although this reduction was seen across all mortality causes, the biggest decrease was in colorectal cancer mortality in individuals who took aspirin three or more times each week. The authors acknowledge that their findings require further investigation and recognize that their findings contrast with results from other studies. This includes the recent Aspirin in Reducing Events in the Elderly (ASPREE) study, which found higher all-cause mortality and cancer-related mortality with aspirin therapy.

In other encouraging news, new research suggests that aspirin is an effective option for acute treatment and prevention of recurrent migraine attacks, particularly among patients who can't tolerate or afford newer, more expensive medications. Primary care providers often treat headache disorders, and many patients either do not have health insurance or face high copays. As the study's senior author, Charles H. Hennekens, MD, DrPH, told Medscape, "We have provided a review of the randomized evidence that suggests that aspirin may be something [physicians] wish to consider in their patients?high doses for treatment, low doses for prevention of recurrent attacks."

In more concerning news, a large registry-based cohort found that combining aspirin and direct oral anticoagulant (DOAC) therapy for the secondary prevention of venous thromboembolism or the prevention of stroke associated with nonvalvular atrial fibrillation without a clear indication was associated with increased bleeding risks. The study of more than 2000 patients at six anticoagulation clinics also found no apparent improvement in thrombosis incidence with the addition of aspirin. Although the authors note that the findings will need to be confirmed by larger studies, the research suggests that caution is warranted when considering this combined therapy.

From potential good news about all-cause mortality and migraine treatment to serious risks in certain settings, a wide range of studies helped make aspirin this week's top trending clinical topic.

Read more about dosing information, indications, and other aspects of aspirin.

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