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Low-dose aspirin not useful for venous ulcers

Question clinique

Is low-dose aspirin effective to promote healing in patients with venous leg ulcers?

L’Essentiel

Adding low-dose aspirin to the usual treatment of leg ulcers is not effective in speeding ulcer healing. Larger studies, using 300 mg daily, are underway. 1b

Référence

Jull A, Wadham A, Bullen C, Parag V, Kerse N, Waters J. Low dose aspirin as adjuvant treatment for venous leg ulceration: pragmatic, randomised, double blind, placebo controlled trial (Aspirin4VLU). BMJ 2017;358:j5157.

Plan de l'etude: Randomized controlled trial (double-blinded)

Financement: Government

Cadre: Outpatient (primary care)

Sommaire

These investigators enrolled 251 adults with an open leg ulcer for at least 4 weeks (median duration 16 weeks) from 5 community health centers in New Zealand. Most participants (90%) did not have a history of diabetes and only 7% had a history of deep vein thrombosis. The patients were stratified by center and by the duration and size of the ulcer and then randomized, using concealed allocation, to receive either placebo or aspirin 150 mg daily in addition to their usual treatment with dressings and compression. Analysis was by intention to treat. The median time to healing was 77 days in the aspirin group and 69 days in the placebo group (P = .25). There were a similar number of participants healed at the end of 24 weeks. Adverse effect rates were similar between the 2 groups.

Reviewer

Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA


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