January 11, 2012BloodOpen Access

Aspirin-insensitive thromboxane biosynthesis in essential thrombocythemia is explained by accelerated renewal of the drug target

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Why the study?

Does a twice-daily aspirin regimen improve platelet inhibition compared to once-daily regimens in patients with essential thrombocythemia?

Population

41 aspirin-treated patients with essential thrombocythemia, of which 21 with serum TXB ≥ 4 ng/mL at 24 hours…

Comparison

Enteric-coated aspirin 100 mg twice daily… vs Crossover comparison between the three aspirin…

Design

RCT, randomized in a crossover design

Follow-up

7 days per regimen

Authors

SPSilvia PascaleUNESCO GPGiovanna PetrucciSaint Camillus International University of Health and Medical Sciences ADAlfredo DraganiOspedale di Santo Spirito

Discussion

Member takes

Implication

Twice-daily aspirin may restore efficacy in essential thrombocythemia; confirms accelerated turnover necessitates dosing-interval adjustment over escalation.

Structured PICO

Does a twice-daily aspirin regimen improve platelet inhibition compared to once-daily regimens in patients with essential thrombocythemia?

Population

41 aspirin-treated patients with essential thrombocythemia (ET), of which 21 with serum TXB(2) ≥ 4 ng/mL at 24 hours after dosing were randomized.

Intervention

Enteric-coated aspirin 100 mg twice daily, enteric-coated aspirin 200 mg once daily, or plain aspirin 100 mg once daily for 7 days

Comparator

Crossover comparison between the three aspirin regimens

Outcome

Serum TXB(2) levels and functional platelet response (assessed by urinary 11-dehydro-TXB(2) excretion and VerifyNow Aspirin assay)surrogate

In essential thrombocythemia, impaired platelet inhibition by low-dose aspirin is due to accelerated platelet turnover and can be rescued by a twice-daily dosing interval rather than increasing the once-daily dose.

Cite This Study

Pascale et al. (2012) studied this question.

synapsesocial.com/papers/6a6f80dd87f9210571272b7c https://doi.org/10.1182/blood-2011-06-359224

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Implication

Twice-daily aspirin may restore efficacy in essential thrombocythemia; confirms accelerated turnover necessitates dosing-interval adjustment over escalation.