ASPREE Aspirin in Reducing Events in the Elderly (ASPREE; 2018)

Question 1

ASPREE Clinical Question

Answer 1

Among healthy, community-dwelling seniors, does low-dose aspirin reduce death, dementia, or persistent physical disability when compared with placebo

Question 2

ASPREE Bottom Line

Answer 2

Among healthy, community-dwelling seniors, low-dose aspirin did not reduce incident death, dementia, or persistent physical disability when compared with placebo. Aspirin was associated with increased risk of major hemorrhage.

Question 3

ASPREE Primary outcome

Answer 3

Disability-free survival

Question 4

ASPREE Inclusion Criteria

Answer 4

Age ≥70 years; age ≥65 if in the US and black or Hispanic

Question 5

ASPREE intervention

Answer 5

• Patients were randomized to either aspirin 100mg of enteric coated aspirin daily or placebo.
• All underwent 4-week placebo run-in phase, patients with 80% adherence as measured by pill count were randomized 1:1
• Patients had in person visits yearly and 3 monthly phone call to encourage retention

Question 6

ASPREE Criticisms

Answer 6

Lack of generalisability to non-white population (91.3% of participants white)
Like the other 2018 trials, low adherence to aspirin (60 to 70% in all trials) and high crossover