gwern comments on Daily Low-Dose Aspirin, Round 2 - Less Wrong

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Comment author: Lumifer 17 August 2013 01:09:52AM *  0 points [-]

If you look at the Rothwell paper linked above by gwern, there's one Japanese study there - JPAD (Ogawa H, Nakayama M, Morimoto T, et al. Japanese Primary Prevention of Atherosclerosis With Aspirin for Diabetes (JPAD) Trial Investigators. Low-dose aspirin for primary prevention of atherosclerotic events in patients with type 2 diabetes: a randomized controlled trial. JAMA 2008; 300: 2134–41).

Looking at the graphs, JPAD effectively showed zero effect of aspirin. I think this supports your thesis.

Comment author: gwern 17 August 2013 01:49:17AM *  1 point [-]

But from JPAD, the specific effects that are supposed to show aspirin benefits weren't what this study measured! They were looking at:

Primary end points were atherosclerotic events, including fatal or nonfatal ischemic heart disease, fatal or nonfatal stroke, and peripheral arterial disease.

This doesn't include anything related to cancer. And to the extent that the study did look at all-cause mortality, it showed exactly what you would expect from a relatively small (n=2539) and short ("median follow-up of 4.37 years") trial where aspirin was yielding benefits: a large but non-statistically-significant effect

A total of 34 patients in the aspirin group and 38 patients in the nonaspirin group died from any cause (HR, 0.90; 95% CI, 0.57-1.14; log-rank test, p=.67).

Comment author: Lumifer 17 August 2013 02:47:44AM 0 points [-]

I haven't looked at the JPAD paper yet, but that Cochrane study plots JPAD results for cancer endpoints as well as major vascular and extracranial bleeds. In the same graphs I don't see large effects.

It's worth pointing out the general low cancer rates (in the controls as well) in the JPAD study.