Twice daily aspirin to improve biological aspirin efficacy in patients with essential thrombocytemia

摘要

Patients with essential thrombocytemia (ET) remain exposed to thrombotic events despite aspirin treatment. Accelerated platelet turnover in ET patients explain rapid recovery of thromboxane-A2 biosynthesis after aspirin intake. Thus, twice daily aspirin could be biologically more effective in these patients. This prospective study assessed the maximal aggregation intensity (MAI) measured by light transmission aggregometry triggered by arachidonic acid. ET patients (n=32) were sequentially treated by low-dose aspirin once daily (100 mg morning; OPD-low), then high-dose aspirin once daily (250 mg morning; OPD-high) and then aspirin divided twice daily (100 mg in the morning and 100 mg in the evening; BID). Mean MAI was 68±12% on OPD-low, 64±19% on OPD-high and 12±16% on BID (p<0.0001). The proportion of patients with aspirin resistance (MAI≥20%) was 97% on OPD-low, 94% on OPD-high and 9% on BID (p<0.0001). This study demonstrates that aspirin administered twice daily is biologically more effective in ET patients independently of the total daily dose.