Key result
Twice-daily aspirin reduces serum thromboxane B2 by ~79% vs once-daily in essential thrombocythemia.
Why the study?
In essential thrombocythemia, once-daily low-dose aspirin is recommended, but accelerated platelet generation may shorten platelet COX-1 inhibition.
Does twice-daily or thrice-daily aspirin 100 mg improve platelet COX-1 inhibition compared to once-daily dosing in patients with essential thrombocythemia?
Population
245 patients with essential thrombocythemia on chronic once-daily low-dose aspirin
Comparison
100 mg aspirin once daily vs twice daily vs 3 times daily
Design
Multicenter double-blind randomized controlled trial
Follow-up
2 weeks
Authors
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Twice-daily aspirin improves platelet COX-1 inhibition in ET; challenges once-daily as standard and supports regimen reevaluation in practice.
RCT (n=245)
Double-blind
1:1:1
Yes
Does twice-daily or thrice-daily aspirin 100 mg improve platelet COX-1 inhibition compared to once-daily dosing in patients with essential thrombocythemia?
Absolute Event Rate: 4% vs 19.3%
Shortening the aspirin dosing interval to 12 hours (twice daily) markedly improves platelet COX-1 inhibition in patients with essential thrombocythemia compared to the standard once-daily regimen.
Rocca et al. (2020) conducted an RCT in Essential thrombocythemia (n=245). Aspirin vs. 100 mg once daily was evaluated on Serum thromboxane B2 (sTXB2) and urinary prostacyclin metabolite (PGIM) excretion. In patients with essential thrombocythemia, shortening the 100 mg aspirin dosing interval to twice daily reduced median serum thromboxane B2 from 19.3 ng/mL to 4 ng/mL compared with once daily.
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