Aspirin lacks efficacy in primary prevention of CVD, cancer
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Aspirin lacks efficacy in primary prevention of CVD, cancer The benefits of aspirin for primary prevention of cardiovascular disease (CVD) or cancer appear to be relatively small, remain statistically uncertain in some scenarios, and are markedly less than those observed for its use in the secondary prevention of CVD, say the authors of a systematic review. Risks, particularly bleeding events, occur at a relatively higher frequency than benefits; however, as with benefits, compared with the epidemiology or total burden of the disease in the population, absolute rates were relatively small. This systematic review included 22 systematic reviews that evaluated aspirin for the primary prevention of cancer, CVD, or CVD in patients with diabetes mellitus and five randomised controlled trials (RCTs) assessing its use in the primary prevention of CVD, or CVD in patients with diabetes. Of note, the systematic reviews of aspirin use in the primary prevention of cancer were based on data from retrospective analyses of the reduction in cancer incidence and mortality in RCTs investigating aspirin for the prevention of CVD. In addition to several relevant ongoing clinical trials (completion dates between 2013 to 2019), the authors’ suggest "the following avenues of future research deserve consideration: investigation of the impact of different dose regimens on CVD and cancer outcomes; further investigation in specific subgroups stratified according to reliable risk assessment tools; and expanding the use of individual patient data metaanalysis of RCTs to the fullest extent possible by pooling data from variously publicly funded international investigations. Sutcliffe P, et al. Aspirin for prophylactic use in the primary prevention of cardiovascular disease and cancer: a systematic review and overview of reviews (scientific summary). Health Technology Assessment 17: [8 pages], No. 43, Sep 803095178 2013. Available from: URL: http://dx.doi.org/0.3310/hta17430
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Reactions 16 Nov 2013 No. 1478
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