TY - JOUR
T1 - Rationale and Design of the Aspirin Dosing-A Patient-Centric Trial Assessing Benefits and Long-term Effectiveness (ADAPTABLE) Trial
AU - Marquis-Gravel, Guillaume
AU - Roe, Matthew T.
AU - Robertson, Holly R.
AU - Harrington, Robert A.
AU - Pencina, Michael J.
AU - Berdan, Lisa G.
AU - Hammill, Bradley G.
AU - Faulkner, Madelaine
AU - Munõz, Daniel
AU - Fonarow, Gregg C.
AU - Nallamothu, Brahmajee K.
AU - Fintel, Dan J.
AU - Ford, Daniel E.
AU - Zhou, Li
AU - Daugherty, Sarah E.
AU - Nauman, Elizabeth
AU - Kraschnewski, Jennifer
AU - Ahmad, Faraz S.
AU - Benziger, Catherine P.
AU - Haynes, Kevin
AU - Merritt, J. Greg
AU - Metkus, Thomas
AU - Kripalani, Sunil
AU - Gupta, Kamal
AU - Shah, Raj C.
AU - McClay, James C.
AU - Re, Richard N.
AU - Geary, Carol
AU - Lampert, Brent C.
AU - Bradley, Steven M.
AU - Jain, Sandeep K.
AU - Seifein, Hani
AU - Whittle, Jeff
AU - Roger, Véronique L.
AU - Effron, Mark B.
AU - Alvarado, Giselle
AU - Goldberg, Ythan H.
AU - Vanwormer, Jeffrey L.
AU - Girotra, Saket
AU - Farrehi, Peter
AU - McTigue, Kathleen M.
AU - Rothman, Russell
AU - Hernandez, Adrian F.
AU - Jones, W. Schuyler
N1 - Publisher Copyright:
© 2020 American Medical Association All rights reserved.
PY - 2020/5
Y1 - 2020/5
N2 - Importance: Determining the right dosage of aspirin for the secondary prevention treatment of atherosclerotic cardiovascular disease (ASCVD) remains an unanswered and critical question. Objective: To report the rationale and design for a randomized clinical trial to determine the optimal dosage of aspirin to be used for secondary prevention of ASCVD, using an innovative research method. Design, Setting, and Participants: This pragmatic, open-label, patient-centered, randomized clinical trial is being conducted in 15000 patients within the National Patient-Centered Clinical Research Network (PCORnet), a distributed research network of partners including clinical research networks, health plan research networks, and patient-powered research networks across the United States. Patients with established ASCVD treated in routine clinical practice within the network are eligible. Patient recruitment began in April 2016. Enrollment was completed in June 2019. Final follow-up is expected to be completed by June 2020. Interventions: Participants are randomized on a web platform in a 1:1 fashion to either 81 mg or 325 mg of aspirin daily. Main Outcomes and Measures: The primary efficacy end point is the composite of all-cause mortality, hospitalization for nonfatal myocardial infarction, or hospitalization for a nonfatal stroke. The primary safety end point is hospitalization for major bleeding associated with a blood-product transfusion. End points are captured through regular queries of the health systems' common data model within the structure of PCORnet's distributed data environment. Conclusions and Relevance: As a pragmatic study and the first interventional trial conducted within the PCORnet electronic data infrastructure, this trial is testing several unique and innovative operational approaches that have the potential to disrupt and transform the conduct of future patient-centered randomized clinical trials by evaluating treatments integrated in clinical practice while at the same time determining the optimal dosage of aspirin for secondary prevention of ASCVD. Trial Registration: ClinicalTrials.gov
AB - Importance: Determining the right dosage of aspirin for the secondary prevention treatment of atherosclerotic cardiovascular disease (ASCVD) remains an unanswered and critical question. Objective: To report the rationale and design for a randomized clinical trial to determine the optimal dosage of aspirin to be used for secondary prevention of ASCVD, using an innovative research method. Design, Setting, and Participants: This pragmatic, open-label, patient-centered, randomized clinical trial is being conducted in 15000 patients within the National Patient-Centered Clinical Research Network (PCORnet), a distributed research network of partners including clinical research networks, health plan research networks, and patient-powered research networks across the United States. Patients with established ASCVD treated in routine clinical practice within the network are eligible. Patient recruitment began in April 2016. Enrollment was completed in June 2019. Final follow-up is expected to be completed by June 2020. Interventions: Participants are randomized on a web platform in a 1:1 fashion to either 81 mg or 325 mg of aspirin daily. Main Outcomes and Measures: The primary efficacy end point is the composite of all-cause mortality, hospitalization for nonfatal myocardial infarction, or hospitalization for a nonfatal stroke. The primary safety end point is hospitalization for major bleeding associated with a blood-product transfusion. End points are captured through regular queries of the health systems' common data model within the structure of PCORnet's distributed data environment. Conclusions and Relevance: As a pragmatic study and the first interventional trial conducted within the PCORnet electronic data infrastructure, this trial is testing several unique and innovative operational approaches that have the potential to disrupt and transform the conduct of future patient-centered randomized clinical trials by evaluating treatments integrated in clinical practice while at the same time determining the optimal dosage of aspirin for secondary prevention of ASCVD. Trial Registration: ClinicalTrials.gov
UR - http://www.scopus.com/inward/record.url?scp=85082415670&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85082415670&partnerID=8YFLogxK
U2 - 10.1001/jamacardio.2020.0116
DO - 10.1001/jamacardio.2020.0116
M3 - Article
C2 - 32186653
AN - SCOPUS:85082415670
SN - 2380-6583
VL - 5
SP - 598
EP - 607
JO - JAMA cardiology
JF - JAMA cardiology
IS - 5
ER -
