Will an Aspirin a Day Keep COPD from Flaring Up?

A recent observational study suggests that aspirin might be instrumental in preventing flare ups of chronic pulmonary obstructive disease (COPD), thereby improving quality of life for those who suffer from breathing difficulties because of it. Of the 1,700 participants followed in the three-year study, 764 reported that they took aspirin daily. The aspirin users in the 2019 study reported fewer flare ups and less shortness of breath than participants in a control group that did not use aspirin. The COPD patients who took aspirin also did better on the 50-question St. George Respiratory Questionnaire score, which measures quality of life in patients with diseases of airway obstruction.

While daily aspirin users reported a lower incidence of flare-ups, the findings need further confirmation, the authors write. “The study demonstrated only a small effect on moderate exacerbations and didn’t indicate that aspirin is as effective as other therapies in reducing exacerbations,” says Amber Lanae Martirosov, PharmD, MSc, BCPS, clinical pharmacy specialist ambulatory care at Henry Ford Health Systems, and clinical assistant professor in the Department of Pharmacy Practice at Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University. “The observational study design also provides some limitations and should be a starting point, not a reason to change clinical practice.”

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Martirosov urged caution when interpreting the results because ratios tend to overestimate data in research. “Additionally, the study did not provide information about dosing, adherence, or duration of aspirin therapy,” she says. “As such, we are not able to make sound recommendations about aspirin therapy in terms of dosing or duration.” More research is needed before healthcare professionals can decide whether to recommend aspirin therapy for COPD.

“With additional research, aspirin may become an adjunctive therapy to reduce morbidity and mortality,” said Martirosov. “However, these studies would require a robust study design and include dosing, plus adverse effects. Recent literature has been released which suggests the risk of bleeding in older adults is something we as practitioners need to assess when determining risk versus benefit of treatment. There are definite advantages to the cost of aspirin compared to other therapies, but this study did not compare the use of aspirin alone. As such, we are also unable to suggest that aspirin should be preferred over current therapies for COPD.”

Some conditions preclude aspirin therapy, even if further research confirms its COPD benefits. Anyone who has a bleeding or clotting disorder, an aspirin allergy or bleeding stomach ulcers, should speak with a healthcare professional before taking aspirin.