A randomized, double-blind trial of three aspirin regimens to optimize antiplatelet therapy in essential thrombocythemia

This phase 2, multicenter, double-blind trial analyzed the use of aspirin (100 mg aspirin once, twice [BID], or three times daily [TID]) for 2 weeks among 245 patients with essential thrombocythemia, as well as serum thromboxane B₂ levels—a validated biomarker of COX-1 activity. Patients assigned to BID and TID dosing had lower median values (4 ng/mL and 2.5 ng/mL, respectively) compared with once daily dosing (19 ng/dL), leading to the conclusion that the antiplatelet response to low-dose aspirin can be improved with BID dosing.