June 2, 2020
Is aspirin safe for patients with IBD?
Daily use of low-dose ASA does not appear to worsen clinical outcomes among patients with IBD.
Patel P, Gao G, Gulotta G, et al. Daily Aspirin Use Does Not Impact Clinical Outcomes in Patients With Inflammatory Bowel Disease. Inflamm Bowel Dis. 2020; Epub ahead of print March 27, 2020; https://doi.org/10.1093/ibd/izaa060
Prior studies of the impact of non-steroidal anti-inflammatory drugs (NSAIDs) on IBD have yielded mixed results. In this study, researchers at the University of Chicago retrospectively analyzed data from 174 IBD patients using daily aspirin and 590 matched controls not using this NSAID. The participants had been enrolled in their institution’s prospective IBD registry between 2008 and 2015. Patients were a median 61 years of age and 80% had Crohn’s disease. The mean disease duration was over 20 years and the median duration of aspirin use was 45 months. Most daily aspirin users were taking a daily dose of 81 mg.
Analyses controlling for a number of variables, from smoking status to age, ethnicity, disease duration and disease activity, showed no increase in hospitalizations, IBD-related complications or IBD surgeries among daily aspirin users. In a subgroup analysis, those receiving doses >81 mg per day were more likely to receive a corticosteroid prescription during the study period than those receiving 81 mg per day (Odds Ratio: 3.36; 95% Confidence Interval: 1.55–6.82; P=0.003).
The authors conclude that low-dose ASA does not affect clinical outcomes among patients with IBD. They hypothesize that the contrast between their findings and prior results showing a negative impact of NSAID use could be attributable to differences in their relative inhibition of cyclooxygenase 1 (COX-1) and COX-2.
Study Design: Retrospective cohort
Funding: The study received funding from the National Institutes of Health
Allocation: Not applicable
Setting: Single-center prospective database
Level of Evidence: 2b (Oxford Levels of Evidence)