Low-dose aspirin in the primary prevention of rheumatoid arthritis: The women's health study
Article first published online: 30 MAR 2010
Copyright © 2010 by the American College of Rheumatology
Arthritis Care & Research
Volume 62, Issue 4, pages 545–550, April 2010
How to Cite
Shadick, N. A., Karlson, E. W., Cook, N. R., Maher, N. E., Buring, J. E. and Lee, I.-M. (2010), Low-dose aspirin in the primary prevention of rheumatoid arthritis: The women's health study. Arthritis Care Res, 62: 545–550. doi: 10.1002/acr.20042
- Issue published online: 30 MAR 2010
- Article first published online: 30 MAR 2010
- Manuscript Accepted: 8 DEC 2009
- Manuscript Received: 22 JUL 2009
- NIH. Grant Numbers: HL-43851, CA-47988, AR-02074, AR-49880, AR-0524, HL-080467
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.
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.
During an average followup of 10 years, 106 women developed definite RA (48 women in the aspirin group and 58 in the placebo group). There was a nonsignificant risk for RA (relative risk [RR] 0.83, 95% confidence interval [95% CI] 0.56–1.21; P = 0.33) associated with aspirin. There were 64 seropositive RA cases (60%) and 42 seronegative RA cases (40%). Aspirin also had no significant effect on either seropositive RA (RR 1.0, 95% CI 0.61–1.63) or seronegative RA (RR 0.62, 95% CI 0.33–1.15).
One hundred milligrams of aspirin taken every other day was not associated with a significant reduction in the risk of developing RA among women in a randomized, double-blind, placebo-controlled trial.