Trial Outcomes & Findings for Low Dose Aspirin for Venous Leg Ulcers (NCT NCT02158806)

NCT ID: NCT02158806

Last Updated: 2019-01-04

Results Overview

Time to event (complete healing defined as intact skin with absence of scab)

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

251 participants

Primary outcome timeframe

24 weeks

Results posted on

2019-01-04

Participant Flow

Participants were screened and recruited from five study sites in New Zealand

Enrolled participants were required to have their family physician confirm they could safely participate in the trial ie had no conditions that required treatment with aspirin and no conditions that contraindicated use of aspirin.

Participant milestones

Participant milestones
Measure
Aspirin
150 mg capsule once daily for up to 24 weeks Aspirin: 150 mg aspirin in capsule form once daily for up to 24 weeks
Placebo
Matching inert capsule once daily for up to 24 weeks Placebo: Matching placebo capsule containing inert bulking agent
Overall Study
STARTED
125
126
Overall Study
COMPLETED
121
121
Overall Study
NOT COMPLETED
4
5

Reasons for withdrawal

Reasons for withdrawal
Measure
Aspirin
150 mg capsule once daily for up to 24 weeks Aspirin: 150 mg aspirin in capsule form once daily for up to 24 weeks
Placebo
Matching inert capsule once daily for up to 24 weeks Placebo: Matching placebo capsule containing inert bulking agent
Overall Study
Death
2
0
Overall Study
Withdrawal by Subject
2
0
Overall Study
Lost to Follow-up
0
3
Overall Study
Moved out of area
0
1
Overall Study
Transferred to palliative care
0
1

Baseline Characteristics

Low Dose Aspirin for Venous Leg Ulcers

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Aspirin
n=125 Participants
150 mg capsule once daily for up to 24 weeks Aspirin: 150 mg aspirin in capsule form once daily for up to 24 weeks
Placebo
n=126 Participants
Matching inert capsule once daily for up to 24 weeks Placebo: Matching placebo capsule containing inert bulking agent
Total
n=251 Participants
Total of all reporting groups
Age, Continuous
60.1 Years
STANDARD_DEVIATION 17.1 • n=99 Participants
56.2 Years
STANDARD_DEVIATION 16.1 • n=107 Participants
58.2 Years
STANDARD_DEVIATION 16.7 • n=206 Participants
Sex: Female, Male
Female
60 Participants
n=99 Participants
58 Participants
n=107 Participants
118 Participants
n=206 Participants
Sex: Female, Male
Male
65 Participants
n=99 Participants
68 Participants
n=107 Participants
133 Participants
n=206 Participants
Race/Ethnicity, Customized
Māori
21 Participants
n=99 Participants
16 Participants
n=107 Participants
37 Participants
n=206 Participants
Race/Ethnicity, Customized
Pasifika
23 Participants
n=99 Participants
30 Participants
n=107 Participants
53 Participants
n=206 Participants
Race/Ethnicity, Customized
Asian
4 Participants
n=99 Participants
5 Participants
n=107 Participants
9 Participants
n=206 Participants
Race/Ethnicity, Customized
NZ European/Pākehā
77 Participants
n=99 Participants
74 Participants
n=107 Participants
151 Participants
n=206 Participants
Race/Ethnicity, Customized
Other
0 Participants
n=99 Participants
1 Participants
n=107 Participants
1 Participants
n=206 Participants
Highest educational attainment
Primary school
9 Participants
n=99 Participants
6 Participants
n=107 Participants
15 Participants
n=206 Participants
Highest educational attainment
Secondary school
66 Participants
n=99 Participants
74 Participants
n=107 Participants
140 Participants
n=206 Participants
Highest educational attainment
Undergraduate
9 Participants
n=99 Participants
17 Participants
n=107 Participants
26 Participants
n=206 Participants
Highest educational attainment
Postgraduate
21 Participants
n=99 Participants
11 Participants
n=107 Participants
32 Participants
n=206 Participants
Highest educational attainment
Vocational/technical
20 Participants
n=99 Participants
17 Participants
n=107 Participants
37 Participants
n=206 Participants
Highest educational attainment
None
0 Participants
n=99 Participants
1 Participants
n=107 Participants
1 Participants
n=206 Participants
Smoking status
Never smoked
62 Participants
n=99 Participants
63 Participants
n=107 Participants
125 Participants
n=206 Participants
Smoking status
Former smoker
47 Participants
n=99 Participants
44 Participants
n=107 Participants
91 Participants
n=206 Participants
Smoking status
Current smoker
16 Participants
n=99 Participants
19 Participants
n=107 Participants
35 Participants
n=206 Participants
Medical history
Diabetes
13 Participants
n=99 Participants
13 Participants
n=107 Participants
26 Participants
n=206 Participants
Medical history
Prior DVT
11 Participants
n=99 Participants
7 Participants
n=107 Participants
18 Participants
n=206 Participants
Medical history
Lower limb joint replacement
16 Participants
n=99 Participants
19 Participants
n=107 Participants
35 Participants
n=206 Participants
Medical history
Prior lower limb fracture
18 Participants
n=99 Participants
23 Participants
n=107 Participants
41 Participants
n=206 Participants
Medical history
Prior treatment for varicosities
35 Participants
n=99 Participants
33 Participants
n=107 Participants
68 Participants
n=206 Participants
Ankle Brachial Index
1.1 Ratio of SBP ankle/SBP arm
STANDARD_DEVIATION 0.1 • n=99 Participants
1.1 Ratio of SBP ankle/SBP arm
STANDARD_DEVIATION 0.1 • n=107 Participants
1.1 Ratio of SBP ankle/SBP arm
STANDARD_DEVIATION 0.1 • n=206 Participants
Reference ulcer area
2.6 square centimetres
n=99 Participants
2.3 square centimetres
n=107 Participants
2.5 square centimetres
n=206 Participants
Compression system
High compression
105 Participants
n=99 Participants
102 Participants
n=107 Participants
207 Participants
n=206 Participants
Compression system
Light compression
11 Participants
n=99 Participants
11 Participants
n=107 Participants
22 Participants
n=206 Participants
Compression system
Hosiery
8 Participants
n=99 Participants
13 Participants
n=107 Participants
21 Participants
n=206 Participants
Compression system
Other
1 Participants
n=99 Participants
0 Participants
n=107 Participants
1 Participants
n=206 Participants

PRIMARY outcome

Timeframe: 24 weeks

Time to event (complete healing defined as intact skin with absence of scab)

Outcome measures

Outcome measures
Measure
Aspirin
n=125 Participants
150 mg capsule once daily for up to 24 weeks Aspirin: 150 mg aspirin in capsule form once daily for up to 24 weeks
Placebo
n=126 Participants
Matching inert capsule once daily for up to 24 weeks Placebo: Matching placebo capsule containing inert bulking agent
Time to Complete Healing of Reference Ulcer
77 days
Interval 56.0 to 98.0
69 days
Interval 56.0 to 98.0

SECONDARY outcome

Timeframe: 24 weeks

Number of participants in each arm with completely healed reference ulcers at 24 weeks

Outcome measures

Outcome measures
Measure
Aspirin
n=125 Participants
150 mg capsule once daily for up to 24 weeks Aspirin: 150 mg aspirin in capsule form once daily for up to 24 weeks
Placebo
n=126 Participants
Matching inert capsule once daily for up to 24 weeks Placebo: Matching placebo capsule containing inert bulking agent
Number of Participants With Healed Venous Leg Ulcers
88 Participants
101 Participants

SECONDARY outcome

Timeframe: Baseline, 24 weeks

Population: Ulcer area estimated using maximum width and length of the ulcer to calculate the area of an ellipse. We have previously shown this approach to be highly correlated with digital calculation of measured area (r=0.92).

Change in estimated ulcer area from baseline to 24 weeks

Outcome measures

Outcome measures
Measure
Aspirin
n=125 Participants
150 mg capsule once daily for up to 24 weeks Aspirin: 150 mg aspirin in capsule form once daily for up to 24 weeks
Placebo
n=126 Participants
Matching inert capsule once daily for up to 24 weeks Placebo: Matching placebo capsule containing inert bulking agent
Change in Estimated Ulcer Area
4.1 square centimetres
Standard Error 0.4
4.8 square centimetres
Standard Error 0.4

SECONDARY outcome

Timeframe: Baseline, 24 weeks

Population: Only participants that provided both baseline and endpoint data were included in the analysis. Hence the number of participants included in this analysis is less than the number randomized.

Mean difference in change in Short Form 36 (SF36) from baseline to 24 weeks. Crude subscale scores for each group are not shown (each crude subscale is scored 0 to 100 at baseline and 24 weeks); higher mean differences in change from baseline to 24 weeks within groups indicate greater change on the subscales for that group.

Outcome measures

Outcome measures
Measure
Aspirin
n=116 Participants
150 mg capsule once daily for up to 24 weeks Aspirin: 150 mg aspirin in capsule form once daily for up to 24 weeks
Placebo
n=115 Participants
Matching inert capsule once daily for up to 24 weeks Placebo: Matching placebo capsule containing inert bulking agent
Change in Health-related Quality of Life (Short Form 36)
Physical Functioning
5.0 units on a scale
Standard Error 2.2
3.8 units on a scale
Standard Error 2.2
Change in Health-related Quality of Life (Short Form 36)
Role Physical
11.7 units on a scale
Standard Error 3.4
10.3 units on a scale
Standard Error 3.4
Change in Health-related Quality of Life (Short Form 36)
Bodily Pain
11.4 units on a scale
Standard Error 2.2
9.0 units on a scale
Standard Error 2.2
Change in Health-related Quality of Life (Short Form 36)
General Health
-1.1 units on a scale
Standard Error 1.4
-0.8 units on a scale
Standard Error 1.4
Change in Health-related Quality of Life (Short Form 36)
Vitality
3.9 units on a scale
Standard Error 1.6
-0.3 units on a scale
Standard Error 1.6
Change in Health-related Quality of Life (Short Form 36)
Social Functioning
5.8 units on a scale
Standard Error 2.2
4.9 units on a scale
Standard Error 2.2
Change in Health-related Quality of Life (Short Form 36)
Role Emotional
10.5 units on a scale
Standard Error 3.1
6.8 units on a scale
Standard Error 3.1
Change in Health-related Quality of Life (Short Form 36)
Mental Health
-1.2 units on a scale
Standard Error 1.4
1.2 units on a scale
Standard Error 1.4

SECONDARY outcome

Timeframe: Baseline, 24 weeks

Population: Only participants that provided both baseline and endpoint data were included in the analysis. Hence the number of participants included in this analysis is less than the number randomised.

Mean difference in change measured by EuroQol 5D (EQ5D 3L) from baseline to 24 weeks. Crude health state scores for each group are not shown (health state is scored 0 to 100 at baseline and 24 weeks); higher mean differences in change from baseline to 24 weeks within groups indicate greater change on health state for that group.

Outcome measures

Outcome measures
Measure
Aspirin
n=116 Participants
150 mg capsule once daily for up to 24 weeks Aspirin: 150 mg aspirin in capsule form once daily for up to 24 weeks
Placebo
n=115 Participants
Matching inert capsule once daily for up to 24 weeks Placebo: Matching placebo capsule containing inert bulking agent
Change in Health-related Quality of Life (EuroQol-5D 3L)
7.4 score on a scale
Standard Error 1.6
4.0 score on a scale
Standard Error 1.7

SECONDARY outcome

Timeframe: 24 weeks

Population: Only participants that provided both baseline and endpoint data were included in the analysis. Hence the number of participants included in this analysis is less than the number randomised.

Mean difference in change in Charing Cross Venous Ulcer Questionnaire (CXVUQ)) from baseline to 24 weeks. Crude subscale scores for each group are not shown (each crude subscale is scored 0 to 100 at baseline and 24 weeks); higher mean differences in change from baseline to 24 weeks within groups indicate greater change on the subscales for that group.

Outcome measures

Outcome measures
Measure
Aspirin
n=115 Participants
150 mg capsule once daily for up to 24 weeks Aspirin: 150 mg aspirin in capsule form once daily for up to 24 weeks
Placebo
n=116 Participants
Matching inert capsule once daily for up to 24 weeks Placebo: Matching placebo capsule containing inert bulking agent
Change in Health-related Quality of Life (Charing Cross Venous Ulcer Questionnaire)
Social function
-6.2 score on a scale
Standard Error 1.3
-4.7 score on a scale
Standard Error 1.3
Change in Health-related Quality of Life (Charing Cross Venous Ulcer Questionnaire)
Domestic activities
-6.6 score on a scale
Standard Error 1.1
-5.2 score on a scale
Standard Error 1.2
Change in Health-related Quality of Life (Charing Cross Venous Ulcer Questionnaire)
Cosmesis
-6.1 score on a scale
Standard Error 1.6
-4.9 score on a scale
Standard Error 1.6
Change in Health-related Quality of Life (Charing Cross Venous Ulcer Questionnaire)
Emotional status
-9.4 score on a scale
Standard Error 1.8
-6.5 score on a scale
Standard Error 1.8
Change in Health-related Quality of Life (Charing Cross Venous Ulcer Questionnaire)
Overall
-7.3 score on a scale
Standard Error 1.2
-5.5 score on a scale
Standard Error 1.2

SECONDARY outcome

Timeframe: 24 weeks

Adherence to study medication as measured by pill counts (agreement between expected number of tablets remaining after healing and days to healing)

Outcome measures

Outcome measures
Measure
Aspirin
n=125 Participants
150 mg capsule once daily for up to 24 weeks Aspirin: 150 mg aspirin in capsule form once daily for up to 24 weeks
Placebo
n=126 Participants
Matching inert capsule once daily for up to 24 weeks Placebo: Matching placebo capsule containing inert bulking agent
Number of Participants With Adherence to Treatment
92 Participants
92 Participants

SECONDARY outcome

Timeframe: 24 weeks

Population: Only participants that reported any reported untoward medical event were included in this analysis.

Total number of different types of adverse events in participants who reported with any untoward medical event

Outcome measures

Outcome measures
Measure
Aspirin
n=40 Number of events
150 mg capsule once daily for up to 24 weeks Aspirin: 150 mg aspirin in capsule form once daily for up to 24 weeks
Placebo
n=37 Number of events
Matching inert capsule once daily for up to 24 weeks Placebo: Matching placebo capsule containing inert bulking agent
Incidence of Adverse Events at 24 Weeks
Cancer
6 Number of events
1 Number of events
Incidence of Adverse Events at 24 Weeks
Cardiovascular
0 Number of events
4 Number of events
Incidence of Adverse Events at 24 Weeks
Gastrointestinal
8 Number of events
4 Number of events
Incidence of Adverse Events at 24 Weeks
Respiratory
3 Number of events
0 Number of events
Incidence of Adverse Events at 24 Weeks
Genitourinary
2 Number of events
0 Number of events
Incidence of Adverse Events at 24 Weeks
Skin & cutaneous
1 Number of events
5 Number of events
Incidence of Adverse Events at 24 Weeks
Accidental injury
4 Number of events
4 Number of events
Incidence of Adverse Events at 24 Weeks
Psychiatric
1 Number of events
0 Number of events
Incidence of Adverse Events at 24 Weeks
Signs & symptoms
7 Number of events
5 Number of events
Incidence of Adverse Events at 24 Weeks
Leg ulcer bleeding
2 Number of events
2 Number of events
Incidence of Adverse Events at 24 Weeks
Leg ulcer infection
2 Number of events
4 Number of events
Incidence of Adverse Events at 24 Weeks
Extension of leg ulcer
1 Number of events
2 Number of events
Incidence of Adverse Events at 24 Weeks
New leg ulcer
1 Number of events
3 Number of events
Incidence of Adverse Events at 24 Weeks
Other
2 Number of events
3 Number of events

Adverse Events

Aspirin

Serious events: 11 serious events
Other events: 20 other events
Deaths: 2 deaths

Placebo

Serious events: 10 serious events
Other events: 18 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Aspirin
n=125 participants at risk
150 mg capsule once daily for up to 24 weeks Aspirin: 150 mg aspirin in capsule form once daily for up to 24 weeks
Placebo
n=126 participants at risk
Matching inert capsule once daily for up to 24 weeks Placebo: Matching placebo capsule containing inert bulking agent
Infections and infestations
Hospitalisation or prolongation of hospitalisation
0.80%
1/125 • Number of events 1 • 24 weeks
2.4%
3/126 • Number of events 3 • 24 weeks
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Hospitalisation or prolongation of hospitalisation
0.80%
1/125 • Number of events 2 • 24 weeks
0.00%
0/126 • 24 weeks
Cardiac disorders
Hospitalisation or prolongation of hospitalisation
0.00%
0/125 • 24 weeks
0.79%
1/126 • Number of events 1 • 24 weeks
Blood and lymphatic system disorders
Hospitalisation or prolongation of hospitalisation
0.80%
1/125 • Number of events 1 • 24 weeks
0.00%
0/126 • 24 weeks
Respiratory, thoracic and mediastinal disorders
Hospitalisation or prolongation of hospitalisation
0.80%
1/125 • Number of events 1 • 24 weeks
0.00%
0/126 • 24 weeks
Gastrointestinal disorders
Hospitalisation or prolongation of hospitalisation
0.80%
1/125 • Number of events 1 • 24 weeks
0.00%
0/126 • 24 weeks
Renal and urinary disorders
Hospitalisation or prolongation of hospitalisation
0.80%
1/125 • Number of events 1 • 24 weeks
0.00%
0/126 • 24 weeks
General disorders
Hospitalisation or prolongation of hospitalisation
0.80%
1/125 • Number of events 2 • 24 weeks
0.00%
0/126 • 24 weeks
Injury, poisoning and procedural complications
Hospitalisation or prolongation of hospitalisation
0.00%
0/125 • 24 weeks
0.79%
1/126 • Number of events 1 • 24 weeks
Surgical and medical procedures
Hospitalisation or prolongation of hospitalisation
0.80%
1/125 • Number of events 1 • 24 weeks
0.00%
0/126 • 24 weeks
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Life threatening event of illness
0.00%
0/125 • 24 weeks
0.79%
1/126 • Number of events 1 • 24 weeks
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Significan medical event
1.6%
2/125 • Number of events 2 • 24 weeks
0.00%
0/126 • 24 weeks
Immune system disorders
Significant medical event
0.00%
0/125 • 24 weeks
0.79%
1/126 • Number of events 1 • 24 weeks
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Death
0.80%
1/125 • Number of events 1 • 24 weeks
0.00%
0/126 • 24 weeks
Respiratory, thoracic and mediastinal disorders
Death
0.80%
1/125 • Number of events 1 • 24 weeks
0.00%
0/126 • 24 weeks

Other adverse events

Other adverse events
Measure
Aspirin
n=125 participants at risk
150 mg capsule once daily for up to 24 weeks Aspirin: 150 mg aspirin in capsule form once daily for up to 24 weeks
Placebo
n=126 participants at risk
Matching inert capsule once daily for up to 24 weeks Placebo: Matching placebo capsule containing inert bulking agent
Respiratory, thoracic and mediastinal disorders
Respiratory tract infection
0.80%
1/125 • Number of events 1 • 24 weeks
0.00%
0/126 • 24 weeks
Blood and lymphatic system disorders
Bleeding from any lower leg ulceration
1.6%
2/125 • Number of events 2 • 24 weeks
1.6%
2/126 • Number of events 2 • 24 weeks
Infections and infestations
Infection of ulceration, any lower leg ulceration
0.80%
1/125 • Number of events 1 • 24 weeks
2.4%
3/126 • Number of events 4 • 24 weeks
Skin and subcutaneous tissue disorders
Developed any new lower leg ulceration
0.80%
1/125 • Number of events 1 • 24 weeks
2.4%
3/126 • Number of events 3 • 24 weeks
Skin and subcutaneous tissue disorders
Extension of reference ulceration
0.80%
1/125 • Number of events 1 • 24 weeks
1.6%
2/126 • Number of events 2 • 24 weeks
Infections and infestations
Candidal stomatitis
0.00%
0/125 • 24 weeks
0.79%
1/126 • Number of events 1 • 24 weeks
Blood and lymphatic system disorders
Coagulation defect, unspecified
0.80%
1/125 • Number of events 1 • 24 weeks
0.00%
0/126 • 24 weeks
Psychiatric disorders
Depressive episode, unspecified
0.80%
1/125 • Number of events 1 • 24 weeks
0.00%
0/126 • 24 weeks
Skin and subcutaneous tissue disorders
Acute inflammation of orbit
0.80%
1/125 • Number of events 1 • 24 weeks
0.00%
0/126 • 24 weeks
Skin and subcutaneous tissue disorders
Varicose veins of lower extremities with inflammation
0.00%
0/125 • 24 weeks
0.79%
1/126 • Number of events 1 • 24 weeks
Vascular disorders
Varicose veins of lower extremities without ulcer or inflammation
0.00%
0/125 • 24 weeks
0.79%
1/126 • Number of events 1 • 24 weeks
Gastrointestinal disorders
Gastro-oesophageal reflux disease without oesophagi's
0.80%
1/125 • Number of events 1 • 24 weeks
0.00%
0/126 • 24 weeks
Gastrointestinal disorders
Gastric ulcer, unspecified as acute or chronic, without haemorrhage or perforation
0.80%
1/125 • Number of events 1 • 24 weeks
0.00%
0/126 • 24 weeks
Gastrointestinal disorders
Gastritis, unspecified
1.6%
2/125 • Number of events 2 • 24 weeks
0.79%
1/126 • Number of events 1 • 24 weeks
Gastrointestinal disorders
Dyspepsia
0.80%
1/125 • Number of events 1 • 24 weeks
0.00%
0/126 • 24 weeks
Gastrointestinal disorders
Functional diarrhoea
0.00%
0/125 • 24 weeks
0.79%
1/126 • Number of events 1 • 24 weeks
Skin and subcutaneous tissue disorders
Cellulitis of lower limb
0.00%
0/125 • 24 weeks
1.6%
2/126 • Number of events 2 • 24 weeks
Renal and urinary disorders
Urinary tract infection, site not specified
0.80%
1/125 • Number of events 1 • 24 weeks
0.00%
0/126 • 24 weeks
Blood and lymphatic system disorders
Epistaxis
0.80%
1/125 • Number of events 1 • 24 weeks
0.00%
0/126 • 24 weeks
Gastrointestinal disorders
Nausea and vomiting
1.6%
2/125 • Number of events 2 • 24 weeks
0.79%
1/126 • Number of events 1 • 24 weeks
Injury, poisoning and procedural complications
Tendency to fall, not elsewhere classified
0.00%
0/125 • 24 weeks
0.79%
1/126 • Number of events 1 • 24 weeks
General disorders
Hyperhidrosis
0.00%
0/125 • 24 weeks
0.79%
1/126 • Number of events 1 • 24 weeks
Injury, poisoning and procedural complications
Laceration and contusions
3.2%
4/125 • Number of events 4 • 24 weeks
0.79%
1/126 • Number of events 1 • 24 weeks
Immune system disorders
Allergy, unspecified
0.00%
0/125 • 24 weeks
0.79%
1/126 • Number of events 1 • 24 weeks

Additional Information

Professor Andrew Jull

University of Auckland

Phone: +64 9 923 4259

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place