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The story of aspirin is as remarkable and wide ranging as its number of potential uses
From origins as a herbal folk medicine – through its extended life as a front line pain killer – and now to its potential applications as a life saving preventive medicine, aspirin’s role is constantly changing. All these developments have come from the efforts of thousands of clinicians and scientists from across the world.
Major historical events
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2000+ BCE
Assyrians document the use of willow leaves for rheumatic inflammation on stone tablets during the Sumerian period
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1550 BCE
the Ebers Papyrus an Egyptian medical text recommended an infusion of dry myrtle leaves for rheumatic and back pain
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c400 BCE
Hippocrates of Kos uses willow bark for fever and pain
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1763
Reverend Edward Stone informs the Royal Society about his success with willow bark to treat fever
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1876
Dr Thomas MacLagan publishes his work using salicin in acute rheumatism
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1897
Dr Felix Hoffmann produces pure stable acetylsalicylic acid from salicylic acid and acetic anhydride
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1853
Salicylic acid made from salicin by French scientists but it is found to irritate the gut.
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1893
German scientists find that adding an acetyl group to salicylic acid reduces its irritant properties.
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1897
In Germany, Bayer’s Felix Hoffmann develops and patents a process for synthesising acetyl salicylic acid or aspirin. First clinical trials begin.
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1971
British Pharmacologist, Sir John Vane discovers that acetylsalicylic acid inhibits the production of pain- intensifying prostaglandins
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1974
Professor Elwood, Archibald Cochrane and their colleagues publish the first RCT using aspirin for secondary CVD prevention
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1974
International Aspirin Foundation founded by Nick Henderson FIPR HonFRCVS
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1985
Professor Carlo Patrono shows that aspirin at low doses permanently inhibits thromboxane
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1988
Physicians Health Study; Nurse’s Health Study and the Women’s Health Study showed positive effects of aspirin in the primary prevention of disease
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1988
Cardiologists start using aspirin as immediate standard practice for suspected MI.
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1988
First study to show a link between aspirin and colorectal cancer prevention
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1997
Aspirin is 100 years old
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2002
Antithrombotic Trialists’ Collaboration publish a meta-analysis confirming aspirin’s role in preventing death, MI and stroke in high risk patients.
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2015
US Preventative Services Task Force recommends aspirin for the prevention of cardiovascular disease and cancer
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2018
Primary prevention trials ARRIVE, ASCEND, ASPREE, seAFOod AspECT published
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2019
International Federation of Gynecology and Obstetrics guidelines recommend that women at high risk of pre-eclampsia take low-dose aspirin prophylaxis
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2020
aspirin is still one of the best options for secondary prevention of cardiovascular disease (The Lancet)
Sources
- Jack DB One hundred years of aspirin. The Lancet 1997:350: 437-39
- Elwood P 2017 Aspirin yesterday, aspirin today, aspirin tomorrow: a history of prophylactic aspirin. International Aspirin Foundation.
- Goldberg DR Aspirin: Turn-of-the century miracle drug accessed 12/05/2019 @ https://wwwsciencehistory.org/distillations/aspirin-turn-of-the-centuary-miracle-drug
- Schrör K 2016 Acetylsalicylic acid. Wiley
- Chiarito M, Sanz-Sánchez J, Cannata F et al monotherapy with P2Y12 inhibitor or aspirin for secondary prevention in patients with established atherosclerosis: a systematic review and meta-analysis. The Lancet 2020 395 10235 14487-1495