A History of Aspirin

166 Clinical Pharmacist September 2014 Vol 6 Vol 6 September 2014 Clinical Pharmacist 167 Aspirin was one of the first drugs to come into common usage and is still one of the Acetylsalicyclic acid is named Aspirin by Bayer. The letter 'A' stands for acetyl, "spir" is derived from the plant known as Spiraea ulmaria (meadowsweet), which yields salicin, and "in" was a common suffix used for drugs at the time of the first stable synthesis of acetylsalicylic acid. Data from the first randomised controlled A meta-analysis suggests that long-term prophylactic use of aspirin has a favourable benefit-harm profile and leads to a dramatic reduction in the incidence of bowel, stomach and oesophageal cancer (Annals of Oncology, online 5 August 2014). trial of aspirin in the secondary prevention of death from heart attack show a reduction in most researched drugs in the world, with an estimated 700 to 1,000 clinical trials conducted each year total mortality of 12% at 6 months and 25% at 12 months but the results are statistically inconclusive (BMJ 1974;1:436). A history of aspirin One Real Aspirin HAYFR may be ineictive, andeven hamfl. L Refuse them. Pro- Counserfeits and subetitutes net younelf by demanding Bayer-Tablets“Aspirin Every tablet and every packnge of geneine Aspirin beas Your Guarantee "The Bayer Cross of Purity" 1950 1991 & 1993 2005 2013 Aspirin enters the Guinness World Results from the CPS (cancer prevention study)-IIl, a large US prospective cohort study, confirm the cancer benefits of aspirin seen in smaller observational studies (NEJM 1991;325:1593 and Cancer Research 1993;53:1322). Follow-up results of the WHS confirm that long-term use of alternate day low-dose aspirin Results from WHS By Dawn Connelly (women's health study), a large, primary-prevention trial among women, suggest that aspirin lowers the risk Records for being the most frequently sold painkiller. 1897 results in a 42% reduction in While working for pharmaceutical company Bayer, German chemist colorectal cancer incidence, with benefits starting to appear after 10 years. The results also show increased risk of gastrointestinal bleeding and peptic ulcers (Annals of Internal Medicine 2013;159:77). of stroke without affecting the risk of heart attack or death Felix Hoffmann, possibly under the direction of 1828 from cardiovascular causes (NEJM 2005;352:1293). The WHS was conducted Joseph Buchner, professor of pharmacy at Munich University, Germany, colleague Arthur Eichengrün, finds that adding an acetyl group to salicylic acid reduces its irritant by investigators from Harvard Medical 2015 succeeds in OXFORDSHIRE BLUE PLAQUES BOARD Results expected from the ARRIVE (aspirin to reduce risk of initial vascular events) study. School. extracting the active ingredient from willow, producing bitter tasting yellow crystals that he names salicin. 1971 The Revd EDWARD STONE properties and Bayer patents the process. John Vane, professor of pharmacology at the University of London, publishes research describing aspirin's mechanism of action (dose-dependent inhibition of prostaglandin synthesis) (Nature New Biołogy 1971;231:232). VE RI 1702-1768 Discovered the active ingredient in Aspirin whilst living near here TAS CHARVARD from 1745 -1768 THE CHIPPING NORTON SOCIETY 2018 Results expected from the ASPREE (aspirin in reducing events in the elderly) study to HO 1763 1876 1997 The Royal Society publishes a report detailing five years of experiments on the use of dried, powdered willow bark in curing fevers, submitted by Edward Stone, a vicar in Chipping Norton, Oxfordshire. The first rigorous Results from the CAST He later wins a Nobel prize (1982) for this work, along with Bengt Samuelsson and Sune Bergström. (Chinese acute stroke trial) study of early aspirin use in 20,000 patients with acute ischaemic stroke show that aspirin started early in hospital produces a small but definite net benefit (Lancet 1997; 349:1641). clinical trial of determine whether the potential benefits of low- dose aspirin outweigh the risks in healthy people older than 70 years of age. salicin finds 2009 that it induces A meta-analysis by the ATT (antithrombotic trialists) collaboration suggests that aspirin has substantial overall benefit in secondary prevention but in primary prevention, aspirin is of uncertain net value as the 1853 remission of French chemist fever and joint Charles Frédéric inflammation Gerhardt determines in patients with rheumatism the chemical structure of salicyclic acid and chemically synthesises acetylsalicylic acid. (Lancet 1876;1:383). с400 ВС reduction in occlusive events In Greece, Hippocrates administers willow needs to be weighed against any increase in major bleeds (Lancet 2009;373:1849). 1998 Results from the HOT (hypertension optimal treatment) trial show that aspirin significantly reduces major cardiovascular events in hypertensive patients, with the greatest benefit seen in preventing heart attacks. The incidence of leaf tea, which contains the natural c3000 – 1500 BC Willow is used as a medicine by ancient civilisations like the Sumerians and Egyptians. The Ebers papyrus, an ancient Egyptian medical text, refers to willow as an anti-inflammatory or pain reliever for non-specific aches and pains. compound from which aspirin is derived, to women to ease the pain of childbirth. 1830 Salicin is also found 2011 in the meadowsweet flower by Swiss pharmacist Johann Pagenstecher and later by German researcher Karl A meta-analysis of eight clinical trials finds that, after five years of follow-up, trial participants who took aspirin daily for a mean of four years have a 44% reduced risk of dying from cancer compared with participants who took a placebo (Lancet 2011;377:31). non-fatal major bleeds was twice as common (Lancet 1998;351;1755). e Jacob Löwig. FEATURE 3000 BC 1500 ВС Ebers papyrus c1500 BC White Willow (Salix alba) 400 ВС 1763 Bayer Pharmaceuticals was the first to produce the aspirin tablet Hippocrates administered Willow leaf tea in ancient Greece 1828 1830 1853 1876 1897 668 1950 1974 1971 English pharmacologist Sir John Robert Vane 1927-2004 Early aspirin in ischaemic stroke produces benefit Study confirms benefit of aspirin in breast cancer 6 months 1991 12 months 1993 1997 1998 2014 2005 6007 2011 2013 2015 2018 FEATURE