On the 28th August 2015 more than 50 scientists and medical professionals from all over the world gathered in London to discuss the current and future uses of aspirin. 

Their consensus was that it was a highly successful meeting in which new aspects of aspirin’s multiple mechanisms of action were first explored, knowledge of which has already led to proposals for its uses well beyond the commonly accepted one of prevention and treatment of arterial thrombosis.

Its role in preventing and treating colorectal cancer, for example, is already proven, with its success against cancer cells and animal models in the laboratory vindicated by randomised trials in healthy subjects and patients. 

Its extension into uses in diabetes mellitus, HIV infection and multiple miscarriages was also highlighted in thought provoking talks and in the final question and answer session involving all the speakers.

Aspirin was first prescribed at the end of the 19th century.  It is known and accepted in every country. 

For over a hundred years it has been the standard by which all other, newer, painkillers have had to be judged, and it has never been found to be inferior.  It is still considered the world’s leading analgesic.

For forty years it has also been the standard treatment for the prevention and treatment of heart attacks.  Its effect on preventing and minimising intra-arterial clotting won the researchers who discovered its effects on platelets the Nobel Prize.  A daily 75mg dose of aspirin has saved countless lives.

The Chair Prof Peter Rothwell MD, PhD, FRCP, FMedSci, Action Research Professor of Neurology, University of Oxford, and the international distinguished speakers shared their knowledge and explained their work. 

The first session, with speakers from Germany, Spain and Italy, in exploring aspirin’s mechanisms of action, explained why aspirin can be so effective in illnesses that seem quite unrelated to its well known anti-inflammatory and anti-thrombotic actions. 

Professor Karsten Schrör of the Heinrich Heine University of Dusseldorf, described new aspects of its biochemistry that add to our knowledge of clotting and of arterial smooth muscle cells. 

Professor Joan Claria of the University of Barcelona described aspirin’s actions on lipids and their relationship to inflammation.  Professor Angel Lanas, of the University of Zaragoza, threw fresh light on the well-known link between aspirin and gastric bleeding, and how it can be resolved. 

And Professor Paola Patrignani, of the School of Medicine in Chieti, discussed (by Skype from Italy) how aspirin affects other aspects of blood clotting mechanisms over and above its established effects on platelet stickiness.

This first session set the scene for the next two sessions, in which clinicians have studied aspirin in disease.  Session two was devoted to its use in cancer treatment and prevention.  Chaired by Dr Ruth Langley, Leading Oncologist at the MRC, University College London, speakers were Professor Andy Chan of Harvard Medical School, on the primary prevention of colorectal cancer, and Farhat Din, consultant colorectal surgeon in the Western General Hospital, Edinburgh on the effects of aspirin in preventing the spread of established colorectal cancer. 

Ruth Langley and Professor Peter Elwood of Cardiff, who first reported aspirin’s reduction of vascular disease mortality 40 years ago, then discussed the future of aspirin as a treatment of other cancers.

Aspirin’s uses are not confined to cancer, as the speakers in session three explained. Professor Graham Hughes, of the London Lupus Centre, was to describe its use in antiphospholipid syndrome, but sadly was taken ill and could not attend.

Professor Carlo Patrono, of the Catholic University of Rome, has established its use in diabetes, in which the risk of intra-arterial thrombosis is high. 

Dr Andrew Freedman, of the University Hospital of Wales in Cardiff, highlighted the benefits of aspirin in patients with HIV, for whom multidrug antiviral treatment has allowed them to live into older age. 

However, their highly raised risk of cardiovascular disease and of cancer makes aspirin an important preventive treatment.   .

The final speaker brought us back to the usual use of aspirin – in acute pain.  Even here, however, there was something new to say, by Professor Ronald Eccles, Director of the Common Cold Centre at Cardiff University. 

Among his studies he included the effects of chilling on the onset of the common cold and the effects of placebos.

Visit ecancertv to watch interviews from the event

Source: Aspirin Foundation