Low‐dose aspirin in the primary prevention of rheumatoid arthritis: The women's health study

Abstract

Objective. Low-dose aspirin may reduce the risk of developing rheumatoid arthritis (RA) through its effect on cyclooxygenase activity and its antioxidant pathways. Previous randomized trial data have demonstrated a beneficial effect of low-dose aspirin in reducing other inflammatory diseases, such as asthma and colorectal adenomas, but no trial has evaluated the role of aspirin in RA prevention. Methods. The Women's Health Study is a randomized, double-blind, placebo-controlled trial conducted between 1992 and 2004 designed to evaluate the risks and benefits of low-dose aspirin (100 mg every other day) and vitamin E in the primary prevention of cardiovascular disease and cancer among 39,876 female health care professionals age >45 years throughout the US. After excluding women with RA at baseline, 39,144 women were evaluated for the present study. A definite diagnosis of RA was assessed during followup by self-report and confirmed using a connective tissue disease screening questionnaire, followed by a medical record review by a rheumatologist for American College of Rheumatology criteria.

Aspirin does not confer protection against major ischemic vascular events in patients diagnosed with rheumatoid arthritis

“…33 In a relatively large study of female healthcare professionals, low-dose ASA was not associated with a significant reduction in risk of RA. 34 Whether ASA can be used for the primary prevention of CVD in patients with RA remains unclear. The present study revealed no difference in the cumulative incidence of major ischemic vascular events between the ASA and non-ASA therapy groups in patients diagnosed with RA, suggesting that ASA does not confer protection against such events in this patient population.…”

“…33 In a relatively large study of female healthcare professionals, low-dose ASA was not associated with a significant reduction in risk of RA. 34…”

When Trust Is Not Enough: A Serial Mediation Model Explaining the Effect of Race Identity, eHealth Information Efficacy, and Information Behavior on Intention to Participate in Clinical Research

“…One of the screens in the survey that was shown to all participants included a page with recruitment information for a hypothetical study for healthy volunteers. The study focused on assessing the dosage of aspirin as a potential disease prevention drug and was based on the existing evidence that daily use of aspirin can prevent many diseases, including heart disease, cancer, and rheumatoid arthritis (Hoffmeister, Chang-Claude, & Brenner, 2007; Shadick et al, 2010; Thun, Jacobs, & Patrono, 2012). Participants were asked to consider joining a study assessing the long-term effects of aspirin on health.…”

A Roadmap for Investigating Preclinical Autoimmunity Using Patient-Oriented and Epidemiologic Study Designs: Example of Rheumatoid Arthritis

“…Pharmacy claims data have also been used for pharmacoepidemiologic studies of RA risk ( 139 , 140 ). Several large placebo-controlled randomized trials, including the Women’s Health Study (investigating vitamin E and aspirin) ( 141 , 142 ), Women’s Health Initiative (investigating postmenopausal hormones) ( 143 ), and VITAL trial (investigating vitamin D and omega-3 fatty acids) ( 144 ) have investigated RA risk as a secondary outcome, the latter suggesting that vitamin D may have potential protection of incident RA and other autoimmune diseases. Finally, the Mayo Clinic and Mass General Brigham Biobanks have been harnessed to analyze electronic health record ( 145 ) and survey data collected prior to RA onset and will use banked blood for future studies ( 75 , 146 – 149 ).…”