CLASP: aspirin

Question 1

CLASP: An RCT of low dose aspirin for the prevention and treatment of PET

Answer 1

Multicentre RCT
N 9364
213 centres, 16 countries
Lancet 1994

Inclusion:
Women 12-32/40 at risk of PET/IUGR and unsure if needs aspirin – randomised to:
- 60mg aspirin
- Placebo

?too low dose
?started too late

Exclusion: inc bleeding risk, asthma, allergy, need immediate delivery, twins

Question 2

Primary outcome CLASP: An RCT of low dose aspirin for the prevention and treatment of PET

Answer 2

Primary outcome:

• PET [6.7% vs 7.6% - only dec 12% - not sig]
• IUGR [no diff]
• Stillbirth [no diff]
• PTB [dec delivery < 37/40 – 19.7% vs 22.2% - abs RR 2.5/100 women]

Question 3

Secondary outcome CLASP: An RCT of low dose aspirin for the prevention and treatment of PET

Answer 3

• Abruption [small inc - not sig]
• Neonatal morbidity [no diff]
• Bleeding [no diff though slight inc transfusion needs]

ASPRE 2017 – aspirin 150mg dec PTB < 37/40 (62% reduction – OR 0.38)

Question 4

Secondary outcome CLASP: An RCT of low dose aspirin for the prevention and treatment of PET