Pharmacokinetic and Pharmacodynamic Profile of a Novel Phospholipid Aspirin Formulation

• Published in: Clinical pharmacokinetics Vol. 61; no. 4; pp. 465 - 479
• Main Authors: Angiolillo, Dominick J., Prats, Jayne, Deliargyris, Efthymios N., Schneider, David J, Scheiman, James, Kimmelstiel, Carey, Steg, Ph. Gabriel, Alberts, Mark, Rosengart, Todd, Mehran, Roxana, Bhatt, Deepak L.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.04.2022; Springer Nature B.V
• Subjects: Acids; Aspirin; Aspirin - pharmacology; Binding sites; Bioavailability; Blood Platelets; Coronaviruses; COVID-19; Disease prevention; Drug dosages; Enzymes; Humans; Internal Medicine; Medicine; Medicine & Public Health; Patients; Pharmacodynamics; Pharmacokinetics; Pharmacology/Toxicology; Pharmacotherapy; Phospholipids; Platelet Aggregation Inhibitors - pharmacology; Platelet Aggregation Inhibitors - therapeutic use; Review; Review Article; Tablets, Enteric-Coated
• DOI: 10.1007/s40262-021-01090-2
• ISSN: 0312-5963; 1179-1926

Aspirin is one of the most widely used medicines. Although aspirin is commonly utilized for the treatment of several medical conditions, its broadest uptake is for the prevention of recurrent ischemic events in patients with atherosclerotic disease. Its mechanism of action of inhibiting platelet activation via blockade of thromboxane A 2 production is unique and is not covered by any other antiplatelet agents. While plain, uncoated, immediate-release aspirin is used in acute settings to help assure rapid absorption, enteric-coated aspirin formulations dominate current chronic use, particularly in North America, including for secondary prevention of cardiovascular events. The unmet needs with current aspirin formulations include a high risk of gastrointestinal (GI) adverse events with plain aspirin, which enteric-coated formulations are not able to overcome, and subject to erratic absorption leading to reduced drug bioavailability. These observations underscore the need for aspirin formulations with a more favorable safety and efficacy profile. Phospholipid-aspirin complex (PL-ASA) is a novel formulation designed to address these needs. It is associated with reduced local acute GI injury compared with plain aspirin, and predictable absorption resulting in more reliable platelet inhibition compared with enteric-coated tablets. This review explores the rationale and pharmacologic profile of PL-ASA intended to address the unmet needs for aspirin therapy.