The ASPREE Trial: An Unanticipated Stimulus for Greater Precision in Prevention?
Menée en Australie et aux Etats-Unis auprès de 19 114 individus âgés d'au moins 65 ans, cette étude analyse l'incidence du cancer et la mortalité associée, en fonction de l'utilisation d'aspirine
The ASPREE (Aspirin in Reducing Events in the Elderly) trial, a large (N=19,114) multi-center, randomized, double-blind, placebo-controlled study examining the effects of low-dose aspirin (100mg daily) on disability-free survival, cardiovascular disease (CVD) and major hemorrhage in the elderly, originally reported its results in three separate papers published in 2018. In this aged population, aspirin use did not prolong disability-free survival over 5 years, nor did it confer cardiovascular
protection, but it statistically significantly increased the rate of major hemorrhage. These results are in line with results from both the ARRIVE (Aspirin to Reduce Risk of Initial Vascular Events) and ASCEND (A Study of Cardiovascular Events in Diabetes) trials, conducted and reported concomitantly with ASPREE. But unlike ARRIVE, ASCEND and nearly all prior primary prevention CVD trials of aspirin, ASPREE surprisingly demonstrated increased all-cause mortality in the aspirin group, which appeared to be driven largely by an increase in cancer-related deaths. These findings have raised important concerns regarding the use of aspirin among the elderly.
Journal of the National Cancer Institute , commentaire en libre accès, 2019