Venous Leg Ulcer Clinical Trial
Official title:
Low Dose Aspirin for Venous Leg Ulcers: a Randomised Trial
Venous leg ulcers (VLU) are the most common leg ulcer, can be painful, and limit work, lifestyles and activity, especially in older patients. There are few effective treatments - compression therapy (tight bandaging or stockings) helps healing, but about half the people with a VLU remain unhealed even after 12 weeks of treatment. Research suggests taking aspirin as well as using compression may speed up healing for VLU, but the current evidence is not enough to change clinical practice. We will conduct a randomised controlled trial to test whether using low dose aspirin (150 mg daily or placebo) really does speed up healing.
A pragmatic, community based, double-blind, placebo-controlled, randomised trial to determine
whether low dose aspirin accelerates venous leg ulcer healing at 24 weeks when used in
addition to compression. Participants in have compression therapy (system of choice guided by
patient and/or clinical preference) as delivered through district nursing services at the
study centres as a background treatment. Low dose aspirin (150 mg) or placebo will be taken
once daily as an oral capsule.
Participants will be district nursing service patients in five study centres in New Zealand
with prevalent or incident venous leg ulcers. A venous leg ulcer will be defined as a wound
on the lower leg that has remained unhealed for 4 or more weeks, appears to be primarily
venous in aetiology with other causative diseases ruled out. If the participant has two or
more venous leg ulcers, the largest ulcer will be the reference ulcer.
Participants will receive three visits from the research nurse - visit 1 to screen for
eligibility, visit 2 to consent and randomise the participant, visit 3 to collect outcome
data. District nurses will continue to visit the participant (about weekly or more frequently
if required) to provide routine care between research nurse visits.
Block randomisation will be used, stratified by study centre and prognostic index (ulcer size
greater than 5cm2 and ulcer duration greater than 6 months) to ensure a balance of
participants within study centres and for participants likely to be slow healers. Research
nurses in the study centres will contact a central telephone answering service, provide
information on inclusion criteria, exclusion criteria, and relevant clinical history on
consented participants. Randomised participants will receive a bottle of 168 capsules of
study medication identified only by unique code and will take the capsule until the reference
ulcer heals or up to 24 weeks, whichever occurs sooner.
Participants will take the study medication for up to 24 weeks or until the reference ulcer
heals. If the participant has a serious adverse event, needs to start taking aspirin, or must
stop taking aspirin to use other medications, they will be withdrawn from treatment, although
they will still be followed up at 24 weeks.
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