The influence of acetylsalicylic acid in bone regeneration: systematic review and meta-analysis

HWO0H ePOSTER BASIC RESEARCH

Background: Acetylsalicylic acid (ASA) is commonly used as a NO-steroidal anti-inflammatory drug that interferes in multiple biological pathways. The ASA's action mechanism acts by inhibiting, cyclooxygenase-1, cyclooxygenase-2, anti-platelet aggregation, and reducing cytokines production. ASA has promoted osteogenesis and inhibited osteoclastogenesis, having the potential of increasing regeneration mediated by mesenchymal cells through the reduction of the interferon-y and tumor necrosis factor-∝.

Aim/Hypothesis: Thus, the objective of this study was to perform a systematic review and meta-analysis to evaluate the effectiveness of the use of ASA in bone regeneration in animal models

Materials and Methods: This review has been structured by PRISMA and recorded in PROSPERO #CDR42018111403. Through the development of search strategies, we identified studies related to the use of ASA from the following databases: 1- Medline (via PubMed); 2- Web of Science; 3- Scopus; 4- Embase. The PICO question was: “Acetylsalicylic acid influences in bone regeneration (outcome) when administrated locally and systemically (intervention) in animal models (population)?” We included trials that used ASA so it would somehow interfere with bone metabolism or be involved in bone regeneration. We only used studies conducted on animals because of the absence of clinical studies in humans on the action of ASA in bone regeneration.

Results: The variation in bone tissue formation in % in the group without local-ASA (6.4% to 78.67%) and in the group with local-ASA (20.15% and 88.81%) was analyzed and showed a greater % in the local-ASA group. A meta-analysis of the amount of bone tissue formed showed a significant advantage when local-ASA was used, revealing a mean difference (MD) of 19.9% (95%CL: 15.39-30.12) P < 0.00001.

Conclusions and Clinical Implications: Within the limitations of the available data, the results were promising and showed that ASA can be effective in bone tissue formation in animal models.

Keywords: Aspirin, Systematic Review, bone regeneration, stem cells