Weight-adjusted aspirin for cardiovascular prevention
Menée à partir des données de 10 essais incluant au total 117 279 participants, cette étude évalue, en fonction de la masse corporelle, de la dose administrée et du sexe, les effets de l'aspirine sur le risque d'événements cardiovasculaires, d'accident vasculaire cérébral et de cancer
Understanding the sources of variability in patients' responses to medicines has the potential to improve efficacy and safety through personalisation of treatment. Individual factors—ie, a patient's risk of cardiovascular events—are already considered when deciding who is prescribed low-dose aspirin for cardiovascular prevention. However, aspirin inhibits just one of several pathways of platelet activation, so it is not surprising that many patients still experience cardiovascular events.1 Factors that potentially contribute to these treatment failures, sometimes named as aspirin resistance, have been studied extensively, and several plausible mechanisms have been suggested, including non-adherence,2 accelerated platelet turnover in patients with diabetes,3 drug interactions with non-steroidal anti-inflammatory drugs,4 reduced bioavailability due to enteric coating,5, 6 and bodyweight.7 Considering these factors when tailoring dose, dosing frequency, and perhaps even time of dosing to individual patients might have substantial public health effects.
The Lancet 2018