Effect of low-dose aspirin on health outcomes: An umbrella review of systematic reviews and meta-analyses
Autor: | Stefano Celotto, Gabriella Pesolillo, Nicola Veronese, Lee Smith, Ioanna Tzoulaki, Joseph Firth, Marco Solmi, Alberto Vaona, Tommaso Barnini, Graziano Onder, Stefania Maggi, John P. A. Ioannidis, Brendon Stubbs, Alberto Pilotto, Ai Koyanagi, Jacopo Demurtas, Trevor Thompson, Evropi Theodoratou |
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Přispěvatelé: | Veronese, N., Demurtas, J., Thompson, T., Solmi, M., Pesolillo, G., Celotto, S., Barnini, T., Stubbs, B., Maggi, S., Pilotto, A., Onder, G., Theodoratou, E., Vaona, A., Firth, J., Smith, L., Koyanagi, A., Ioannidis, J.P.A., Tzoulaki, I. |
Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
Population Lower risk Placebo 030226 pharmacology & pharmacy Systematic Reviews and Meta‐analysis Risk Assessment law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine medicine Humans Pharmacology (medical) aspirin cancer cardiovascular disease meta-analysis umbrella review 030212 general & internal medicine education Pharmacology Aspirin education.field_of_study business.industry technology industry and agriculture medicine.disease Meta-analysis Observational study lipids (amino acids peptides and proteins) Upper gastrointestinal bleeding business Gastrointestinal Hemorrhage medicine.drug |
Zdroj: | BRITISH JOURNAL OF CLINICAL PHARMACOLOGY r-FSJD: Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu Fundació Sant Joan de Déu Veronese, N, Demurtas, J, Thompson, T, Solmi, M, Pesolillo, G, Celotto, S, Barnini, T, Stubbs, B, Maggi, S, Pilotto, A, Onder, G, Theodoratou, E, Vaona, A, Firth, J, Smith, L, Koyanagi, A, Ioannidis, J P A & Tzoulaki, I 2020, ' Effect of low-dose aspirin on health outcomes : An umbrella review of systematic reviews and meta-analyses ', British Journal of Clinical Pharmacology . https://doi.org/10.1111/bcp.14310 Br J Clin Pharmacol r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu instname |
ISSN: | 0306-5251 1365-2125 |
Popis: | Aims:\ud \ud This study aimed to use an umbrella review methodology to capture the range of outcomes that were associated with low‐dose aspirin and to systematically assess the credibility of this evidence.\ud \ud Methods:\ud \ud Aspirin is associated with several health outcomes, but the overall benefit/risk balance related to aspirin use is unclear. We searched three major databases up to 15 August 2019 for meta‐analyses of observational studies and randomized controlled trials (RCTs) including low‐dose aspirin compared to placebo or other treatments. Based on random‐effects summary effect sizes, 95% prediction intervals, heterogeneity, small‐study effects and excess significance, significant meta‐analyses of observational studies were classified from convincing (class I) to weak (class IV). For meta‐analyses of RCTs, outcomes with random effects P ‐value < .005 and a moderate/high GRADE assessment, were classified as strong evidence. From 6802 hits, 67 meta‐analyses (156 outcomes) were eligible.\ud \ud Results:\ud \ud Observational data showed highly suggestive evidence for aspirin use and increased risk of upper gastrointestinal bleeding (RR = 2.28, 95% CI: 1.97–2.64). In RCTs of low‐dose aspirin, we observed strong evidence for lower risk of CVD in people without CVD (RR = 0.83; 95% CI: 0.79–0.87) and in general population (RR = 0.83; 95% CI: 0.79–0.89), higher risk of major gastrointestinal (RR = 1.47; 95% CI: 1.26–1.72) and intracranial bleeding (RR = 1.34; 95% CI: 1.18–1.53), and of major bleedings in people without CVD (RR = 1.62; 95% CI: 1.26–2.08).\ud \ud Conclusion:\ud \ud Compared to other active medications, low‐dose aspirin had strong evidence for lower risk of bleeding, but also lower comparative efficacy. Low‐dose aspirin significantly lowers CVD risk and increases risk of bleeding. Evidence for multiple other health outcomes is limited. |
Databáze: | OpenAIRE |
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