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Evidence summaries

Low-Dose Aspirin for Patients with Polycythaemia Vera

Low-dose aspirin appears to be effective and safe preventing thrombotic complications in patients with polycythemia vera who have no contraindications to such treatment. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 2 studies with a total of 630 subjects. The use of aspirin, compared with placebo, was associated with a lower risk of fatal thrombotic events although this benefit was not statistically significant (OR 0.20, 95% CI 0.03 to 1.14) and did not increase the risk of major bleeding (OR 0.99, 95% CI 0.23 to 4.36). In absolute terms, out of 1 000 people treated with aspirin, three people had a fatal thrombotic event, compared with 22 people treated with placebo (risk difference: 1.9%, 95% CI 0% to 4%). A non-significant benefit of aspirin was also shown for overall mortality (OR 0.46, 95% CI 0.21 to 1.01). No studies have been published in patients with essential thrombocythaemia or studying other antiplatelet drugs.

Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison).

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    References

    • Squizzato A, Romualdi E, Passamonti F et al. Antiplatelet drugs for polycythaemia vera and essential thrombocythaemia. Cochrane Database Syst Rev 2013;(4):CD006503. [PubMed].

Primary/Secondary Keywords