Suggestions that aspirin may help treat venous leg ulcers have been rebutted by University of Auckland research, leaving the sufferers with compression therapy, a treatment known since the 17th Century.
Venous ulcers are chronic wounds of the lower leg. They are more common in older people. District nurses and general practitioners manage most venous ulcers in the community. They are often painful, disabling and very slow to heal.
About 1 percent of the adult population will develop a venous leg ulcer during any one year. Compression therapy, either in the form of bandage systems or hosiery, is the main treatment. But in trials of venous leg ulcers about half the participants remain unhealed after three months of treatment.
Some evidence suggested aspirin might increase venous ulcer healing, but a new randomised controlled trial just published in the British Medical Journal challenges that view.
Funded by the New Zealand Health Research Council and conducted by researchers at the University's National Institute for Health Innovation, Aspirin4VLU trial found 150 mg aspirin a day in addition to compression bandaging did not increase venous ulcer healing.
Seven out of every 10 people with leg ulcers who took aspirin healed within six months compared with eight out of every 10 people in the placebo group.
Associate Professor Andrew Jull who led the trial says while he had hoped aspirin might help with healing, it is still good news. "It means people who have a venous leg ulcer and who have to take aspirin for other reasons still heal at a pretty good rate if they use compression."
The researchers recruited 251 participants through community nursing services in Dunedin, Christchurch, the Waikato, Counties Manukau and Auckland district health boards over two years from 2015.
"We will shortly be getting in touch with the participants to let them and their doctors know which drug they were taking," says Dr Jull. "We remain very grateful to those people who came forward to be part of the study – without them we would not have the evidence to help others."
Aspirin4VLU is the world's largest aspirin trial yet conducted for patients with venous ulcers and the only trial of low dose aspirin.
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Andrew Jull et al. Low dose aspirin as adjuvant treatment for venous leg ulceration: pragmatic, randomised, double blind, placebo controlled trial (Aspirin4VLU), BMJ (2017). DOI: 10.1136/bmj.j5157