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Aspirin for prophylactic use in the primary prevention of cardiovascular disease and cancer. A systematic review and overview of reviews |
Sutcliffe P, Connock M, Gurung T, Freeman K, Johnson S, Kandala NB, Grove A, Gurung B, Morrow S, Clarke A |
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Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Sutcliffe P, Connock M, Gurung T, Freeman K, Johnson S, Kandala NB, Grove A, Gurung B, Morrow S, Clarke A. Aspirin for prophylactic use in the primary prevention of cardiovascular disease and cancer. A systematic review and overview of reviews. Health Technology Assessment 2013; 17(43): 1-253 Authors' objectives To identify RCTs, systematic reviews and meta-analyses of RCTs of the prophylactic use of aspirin in primary prevention of CVD or cancer. To undertake a quality assessment of identified systematic reviews and meta-analyses using meta-analysis to investigate study-level effects on estimates of benefits and risks of adverse events; cumulative meta-analysis; exploratory multivariable meta-regression; and to quantify relative and absolute risks and benefits. Authors' conclusions We have found that there is a fine balance between benefits and risks from regular aspirin use in primary prevention of CVD. Effects on cancer prevention have a long lead time and are at present reliant on post hoc analyses. All absolute effects are relatively small compared with the burden of these diseases. Several potentially relevant ongoing trials will be completed between 2013 and 2019, which may clarify the extent of benefit of aspirin in reducing cancer incidence and mortality. Future research considerations include expanding the use of IPD meta-analysis of RCTs by pooling data from available studies and investigating the impact of different dose regimens on cardiovascular and cancer outcomes. Indexing Status Subject indexing assigned by NLM MeSH Adult; Aged; Aspirin /adverse effects /therapeutic use; Cardiovascular Diseases /mortality /prevention & Colorectal Neoplasms /mortality /prevention & Confidence Intervals; Female; Gastrointestinal Hemorrhage /chemically induced /epidemiologys; Incidence; Male; Middle Aged; Neoplasms /mortality /prevention & Odds Ratio; Primary Prevention /methods; Prognosis; Randomized Controlled Trials as Topic; Risk Assessment; Survival Analysis; United States; control; control; control Language Published English Country of organisation England English summary An English language summary is available. Address for correspondence NETSCC, Health Technology Assessment, Alpha House, University of Southampton Science Park, Southampton, SO16 7NS UK Tel: +44 23 8059 5586 Email: hta@hta.ac.uk AccessionNumber 32013000702 Date abstract record published 09/10/2013 |
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