The principal investigators from five recently completed major aspirin trials (ARRIVE1, ASCEND2, ASPREE3-5, AspECT6 and seAFOod7) met at the Royal Society of Edinburgh on the 20th September 2018 to share their interpretation of important new findings. The delegates and presenters included professors of neurology, epidemiology, gastroenterology, oncology and pharmacology. This meeting facilitates scientists to connect, debate and clarify the knowledge base for current aspirin use and further investigation.
The International Aspirin Foundation is unique in its ability to bring together global experts in aspirin to a forum in which in-depth and energetic debate of the currently available data can take place. This meeting gathered respected scientists from many different disciplines of medicine and science, which allowed challenge and sophisticated discussion of the recently completed aspirin trials with other delegates and the principal investigators.
Professor John McNeil, Head of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia presented his data for the first time taking the audience through the ASPREE trial. The ARRIVE trial was presented on behalf of Professor J Michael Gaziano by Professor Peter Rothwell, Professor of Neurology at the University of Oxford, world expert in aspirin and member of the ARRIVE Steering Committee. Jane Armitage, Professor of Clinical Trials and Epidemiology at the University of Oxford presented the ASCEND data. The AspECT trial findings were delivered by Professor Janusz Jankowski from NICE, UK and Professor Mark Hull from the University of Leeds took the audience through the findings and interpretation of the seAFOod trial.
The pharmacologists at the meeting, including Professor Paola Patrignani and Professor Carlo Patrono, added to the discussion by helping to put the new clinical findings into the context of what is known about the mechanism of action of aspirin and drew attention to the many factors that can influence its pharmacokinetics and pharmacodynamics in humans.
Great value was brought to the meeting by the quality of the audience. Amongst the delegates were Dr Andrew Chan, a gastroenterologist from Harvard Medical School, USA; Dr John Chia, Consultant Oncologist, Singapore; Ruth Langley, Professor of Oncology and Clinical Trials from London; Dr Asad Umar and Dr Leslie Ford from the National Cancer Institute USA; Professor Jack Cuzick, renowned expert in cancer prevention from Queen Mary University of London and Professor Peter Elwood eminent epidemiologist from Cardiff. They asked many stimulating questions and made valuable comments on the data and this added to the overall scientific utility of the event.
This unique meeting demonstrates that the future is exciting for this 121-year-old medicine, as researchers continue to strive to build the knowledge that is vital for enabling the safe use of aspirin in the appropriate clinical context.
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- Gaziano JM, Brontons C, Coppolecchia R et al. Use of aspirin to reduce risk of initial vascular events in patients at moderate risk of cardiovascular disease (ARRIVE): a randomised, double-blind, placebo-controlled trial. The Lancet. 2018; 392; 10152: 1036-1046. (ARRIVE = Aspirin to Reduce Risk of Initial Vascular Events).
- The ASCEND Study Collaborative Group. Effects of Aspirin for Primary Prevention in Persons with Diabetes Mellitus. NEJM 2018 DOI: 10.1056/NEJMoa1804988 (ASCEND = A Study of Cardiovascular Events iN Diabetes).
- McNeil JJ, Woods RL and Nelson MR et al. Effect of Aspirin on Disability-free Survival in the Healthy Elderly. NEJM. 2018 DOI:10.1056/NEJMoa1800722 (ASPREE = ASPirin in Reducing Events in the Elderly).
- McNeil JJ, Nelson MR and Woods RL et al. Effects of Aspirin on All-Cause Mortality in the Healthy Elderly. NEJM. 2018 DOI: 10.1056/NEJMoa1803955 (ASPREE).
- McNeil JJ, Wolfe R and Woods RL et al. Effect of Aspirin on Cardiovascular Events and Bleeding in the Healthy Elderly. NEJM 2018 DOI: 10.1056/NEJMoa1805819 (ASPREE).
- Jankowski JAZ, de Caestecker J, Love SB et al. Esomeprazole and aspirin in Barrett’s oesophagus (AspECT): a randomised factorial trial. 2018 The Lancet; 392;10145:400-408. (AspECT = Aspirin and Esomeprazole Chemoprevention Trial).
- SeAFOod = Systematic Evaluation of Aspirin and Fish Oil awaiting publication.