The following is a summary of “Effectiveness of Aspirin on Major COPD Outcomes: A Prevalent New-User Design Observational Study,” published in the March 2024 issue of Pulmonology by Khouri et al.

Prior studies linking aspirin use in chronic obstructive pulmonary disease (COPD)  to lower death rates and COPD flare-ups may be unreliable due to time-related biases.

Researchers conducted a retrospective study using a prevalent new-user design to assess the association between aspirin use and COPD exacerbations, avoiding biases in previous observational studies.

They utilized the Clinical Practice Research Datalink (CPRD) of the United Kingdom to establish a COPD patient cohort. Based on time and propensity score, aspirin starters were paired with non-users (2002 to 2018).

The results showed that the study assessed all-cause mortality and COPD exacerbation within a one-year follow-up. Using an as-treated approach, HR and 95% CI were computed for each outcome with aspirin use compared to nonuse. The study enrolled 10,287 aspirin initiators and an equivalent number of matched nonusers. At one year, the cumulative incidence of all-cause mortality stood at 11.5% for aspirin users and 9.2% for nonusers. The HR for all-cause mortality linked with starting aspirin was 1.22 (95% CI: 1.08–1.37), and for severe exacerbation, it stood at 1.21 (95% CI: 1.08–1.37), in contrast to nonuse. The HR for the initial moderate or severe exacerbation with aspirin use was also 0.90 (95% CI: 0.85–0.95).

Investigators concluded that while aspirin use in COPD patients correlated with a lower risk of moderate exacerbations, it also showed a slightly increased risk of death and severe exacerbations, warranting further investigation.

Source: tandfonline.com/doi/full/10.1080/15412555.2024.2317380