- Among patients with COPD, daily aspirin use is associated with fewer moderate acute exacerbations of COPD (AECOPD), especially among those with chronic bronchitis.
- Randomized clinical trials are needed.
Why this matters
- Standard COPD therapies do not address systemic component, including inflammation.
- Some studies link aspirin use to lower mortality, other favorable outcomes in COPD.
- 764 participants (45%) reported daily aspirin use at baseline.
- Propensity-matched pairs followed for median 2.7 years.
- Among aspirin users vs nonusers:
- AECOPD incidence rate ratio (IRR): 0.78 (95% CI, 0.65-0.94).
- Result driven by reductions in moderate but not severe exacerbation.
- Subgroup with chronic bronchitis experienced greater benefit (IRR, 0.66; 95% CI, 0.51-0.86).
- On cross-sectional analysis:
- Aspirin users had less moderate-to-severe dyspnea.
- They had numerically but not clinically significant advantages in baseline health status, health-related QoL.
- No significant between-group difference in 6-minute walk distance.
- Analysis of participants with COPD in observational cohort SPIROMICS study (n=1698).
- Researchers compared outcomes in 503 propensity-matched pairs of self-reported aspirin users and nonusers.
- Primary outcome: number of moderate and severe AECOPD.
- Funding: NIH; multiple industry contributors.
- Self-report can be unreliable.
- Dose, duration, and adherence not assessed.
- Mild AECOPD not investigated.
- Potential residual confounders.