AI Article Synopsis
- Low-dose aspirin is used for preventing venous thromboembolism (VTE) in patients undergoing total joint replacement, but this study compares the safety and effectiveness of chewable versus enteric-coated versions.
- A retrospective analysis of over 9,000 patients showed that while there were no significant differences in VTE and gastrointestinal complications overall, chewable aspirin was more effective for preventing VTE specifically in total knee arthroplasty patients.
- The study concludes that while both formulations of aspirin are generally effective, chewable aspirin outperforms enteric-coated aspirin for VTE prophylaxis in total knee arthroplasty cases, without an increase in GI issues.
Article Abstract
Background: Low-dose aspirin is an effective venous thromboembolism (VTE) prophylactic medication in primary total joint arthroplasty, but the efficacy and safety of the formulations of chewable and enteric-coated aspirin have not been compared. The purpose of this study was to investigate the VTE and gastrointestinal (GI) complication rates of chewable and enteric-coated 81 mg aspirin bis in die for VTE prophylaxis in primary total joint arthroplasty.
Methods: A retrospective, single-institution cohort study was performed on patients who underwent primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) from 2017 to 2021. Comparisons were made between 4,844 patients who received chewable, noncoated aspirin 81 mg and 4,388 patients who received enteric-coated 81 mg aspirin. Power analysis demonstrated 1,978 and 3,686 patients were needed per group to achieve a power of 80% for 90-day VTE rates (using inferiority testing) and GI complications (using superiority testing), respectively. Patients had similar baseline characteristics. Statistical analyses were done using t-tests and Chi-squared tests, with statistical significance defined as a P value < .05.
Results: There were no significant differences in the incidences of postoperative VTE (0.31% versus 0.55%; P = .111) or GI complications (0.14% versus 0.14%; P = 1.000) between patients who received either chewable or enteric-coated 81 mg aspirin bis in die in the overall comparison that included both THA and TKA patients combined, or THA patients alone. However, the VTE incidence for TKA patients alone was significantly lower with chewable than enteric-coated aspirin (0.22% versus 0.62%; P = .037), with no difference in GI complications (0.13% versus 0.19%; P = .277).
Conclusions: Low-dose aspirin in enteric-coated formulation is inferior to chewable aspirin for VTE prophylaxis in primary TKA, but not inferior in THA patients. Both formulations have a similar GI complication rate. Therefore, it is reasonable to consider a transition from enteric-coated to uncoated chewable low-dose aspirin.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.arth.2024.06.023 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A Chinese CADASIL family with a rare heterozygous mutation in exon 2 of NOTCH3: A case report.
Medicine (Baltimore)
October 2024
Department of Neurology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China.
Rationale: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an inherited cerebrovascular disease caused by the neurogenic locus notch homolog protein 3 (NOTCH3) gene mutation. In recent years, most of the newly reported mutations of CADASIL patients mainly occur in exon 3 to 24, while the cases related to exon 2 mutation are rare, and clinical research data are relatively insufficient. In this study, we have reported a case of a rare heterozygous mutation c.
View Article and Find Full Text PDFLong-Term Effects of Low-Dose Aspirin on Gastrointestinal Symptoms and Bleeding Complications in Patients with Type 2 Diabetes.
Am J Cardiovasc Drugs
September 2024
Department of Data Science, Hyogo Medical University, 1-1 Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan.
Article Synopsis
- The JPAD trial studied the long-term effects of low-dose aspirin on gastrointestinal symptoms and bleeding in diabetic patients, comparing those taking aspirin to those not taking it.
- Among 2535 participants, the aspirin group experienced a significantly higher rate of gastrointestinal issues, with 8.8% compared to 5.7% in the no-aspirin group at 18 years.
- The risk was notably higher within the first 3 years, particularly for buffered aspirin, suggesting that these factors should influence decisions on starting and continuing low-dose aspirin for prevention.
Effectiveness of long-term low-dose aspirin in the prevention of gastric cancer after Helicobacter pylori eradication: study design and rationale of Ardabil gastric cancer randomized placebo-controlled prevention trial (AGCPT).
Trials
September 2024
Digestive Oncology Research Center (DORC), Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Article Synopsis
- The study, named the Ardabil gastric cancer randomized placebo-controlled prevention trial (AGCPT), aims to assess the effectiveness of long-term low-dose aspirin in preventing gastric cancer development and mortality after H. pylori eradication in a population with high cancer rates.
- It is a large-scale, double-blind trial involving 21,000 participants aged 35 to 70 in Ardabil, Iran, who undergo H. pylori testing and potential eradication before being randomized into either an aspirin treatment group or a placebo group for a 10-year follow-up.
- The findings may have significant implications for public health strategies regarding gastric cancer prevention and could influence future research in the area.
Lignin Nanoparticles as pH-responsive Nanocarriers for Gastric-Irritant Oral Drug Aspirin.
Curr Drug Deliv
September 2024
Department of Applied Chemistry and Chemical Engineering, University of Chittagong, Chittagong-4331, Bangladesh.
Introduction: Although lignin is one of the most naturally abundant biopolymers, the overall status of its utilization has long been subpar. The ability of Lignin to readily self-assemble into nanoparticles, along with its good biocompatibility and minimal toxicity, makes it a perfect agent for nanocarriers and drug delivery.
Method: Hence, in this study, we have attempted to examine lignin nanoparticles (LNPs) as an efficient pH-responsive nanocarrier for gastric-irritant oral NSAID, aspirin.
Effect of particle size on gastric emptying of enteric-coated granules in fasted beagle dogs: Relationship with interdigestive migrating motor complex.
J Pharm Sci
October 2024
Faculty of Pharmaceutical Sciences, Setsunan University, 45-1 Nagaotoge-cho, Hirakata, Osaka 573-0101, Japan.
This study investigates the particle size threshold at which the interdigestive migrating motor complex (IMMC) becomes active in gastric emptying for fasted beagle dogs. Enteric-coated granules containing cetirizine dihydrochloride (CET) were prepared in three particle sizes, 200, 660, and 1,200 µm (D). To mark IMMC timing and water movement from the stomach, enteric-coated aspirin tablets and acetaminophen solution were used.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!