Interindividual variability in the pharmacological response to low-dose aspirin exists due to specific pathophysiological mechanisms, calling for new studies to test alternative regimens.
Highlights the clinical relevance of interindividual variability in aspirin responsiveness and calls for new studies to test optimized low-dose aspirin regimens.
The main pharmacological aspects of pharmacodynamics (PD) and pharmacokinetics (PK) of aspirin as antiplatelet agent were unravelled between the late sixties and the eighties, and low-dose aspirin given once daily has been shown to be a mainstay in the current treatment and prevention of cardiovascular disorders. Nevertheless, several PD and PK aspects of aspirin in selected clinical conditions have recently emerged and deserve future clinical attention. In 1994, the term "aspirin resistance" was used for the first time, but, until now, no consensus exists on definition, standardized assay, underlying mechanisms, clinical impact, and possible efficacy of alternative therapeutic interventions. At variance with an undefined aspirin-resistant status, in the last 5 years, the concept of variability in response to aspirin due to specific pathophysiological mechanisms and based on PK and/or PD of the drug has emerged. This growing evidence highlights the existence and possible clinical relevance of an interindividual variability of pharmacological aspirin response and calls for new, large studies to test new low-dose aspirin-based regimens which may ameliorate platelet acetylation, reduce variability in drug responsiveness, and improve clinical efficacy on selected populations.
Rocca et al. (Wed,) conducted a review in Cardiovascular disorders. Low-dose aspirin was evaluated. Interindividual variability in the pharmacological response to low-dose aspirin exists due to specific pathophysiological mechanisms, calling for new studies to test alternative regimens.