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'Resistance' to low-dose aspirin therapy extremely rare
Date:12/5/2012

oked for aspirin resistance using the platelet test, it detected it in about one-third of our volunteers," said Grosser. "But, when we looked a second time at the incidence of aspirin resistance in the volunteers, the one-third that we measured who was now resistant was mostly different people. Nobody had a stable pattern of resistance that was specific to coated aspirin."

Presently a blood test using a specific device can be used in the doctor's office to diagnose "aspirin resistance." Alternatively, an FDA-approved urine test is available for an indirect marker of platelet stickiness. Either can be used to determine if a patient is likely to benefit from aspirin. However, neither approach was supported by the Penn study. The blood test picked up pseudoresistance, while the urine test failed even to segregate these individuals from those clearly responsive to aspirin.

To address the reason for this pseudoresistance, the researchers compared test results of coated aspirin with the same dose of regular uncoated aspirin in volunteer subgroups for coated versus immediate-release, uncoated aspirin. Resistance was absent in the group that took the uncoated aspirin.

The coating delayed absorption compared to immediate-release, uncoated aspirin. This led to a false impression of aspirin resistance in people taking coated aspirin. Platelets of such patients remained sensitive to aspirin when examined in a test tube, so they were not truly resistant to the action of aspirin.

Uncoated, immediate-release aspirin is generic and cheap - less than 1 cent per pill but most low-dose aspirin taken in the U.S. is the more expensive, coated, branded variety. Although supposedly easier on the stomach, coating of aspirin has never been shown to reduce the likelihood of serious stomach bleeds compared to the same dose of uncoated aspirin.

"These studies question the value of coated, low-dose aspirin," notes FitzGerald. "This product adds
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Contact: Karen Kreeger
karen.kreeger@uphs.upenn.edu
215-349-5658
University of Pennsylvania School of Medicine
Source:Eurekalert  

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