ABSTRACT

Rationale

Enhanced platelet activation is a characteristic feature of Essential Thrombocythemia (ET), and several groups have demonstrated elevated levels of platelet activation markers like thromboxane B2 (TXB2) generation and increased urinary excretion of thromboxane metabolites in patients with ET attributed to increased platelet turnover. This variability in platelet response has led to the suggestion that twice daily dosing of ASA could be more efficacious than once daily dose.

Objective

This review aims to assess the effectiveness of once-daily vs twice-daily low-dose aspirin dosing regimen in adults with Essential Thrombocythemia.

Research Design and Methodology

A systematic search of databases was conducted using the Cochrane Central Register of Controlled Trials, PubMed, and clinicaltrials.gov to identify potentially relevant articles from inception to July 2023. The findings from the individual studies were summarized.

Results

Three studies were included based on the eligibility criteria. All included studies have assessed and reported a significant reduction in either thromboxane or maximal aggregation intensity in the twice-daily regimen vs the once-daily regimen.

Discussion and Conclusion

The studies reported notable improvements and significant differences in laboratory parameters related to platelet inhibition when using a twice-daily dosing regimen; however, large, high-quality RCTs are still needed to support this regimen in clinical practice, particularly its use in hyperproliferative neoplasms such as essential thrombocythemia.