New study to test whether aspirin benefits people with brain cavernoma
Southampton researchers will jointly lead a new £3.5m UK-wide study of a potential treatment for a cluster of abnormal blood vessels in the brain.
The CARE-Aspirin study aims to address a critical gap in the treatment of cavernoma.
It will evaluate whether aspirin prevents stroke due to cavernoma better than a placebo. It will also assess whether aspirin changes the size or look of cavernomas.
The innovative project will be jointly led by Professor Diederik Bulters at University Hospital Southampton (UHS) and Professor Rustam Al-Shahi Salman at the University of Edinburgh.
New approach to preventing stroke
A cavernoma is a small group of abnormal blood vessels in the brain. These behave differently from normal blood vessels.
Typically, cavernomas look like a raspberry, filled with blood that flows slowly through vessels that are like 'caverns'.
Most people with cavernoma will have no symptoms. However, clotting or bleeding in the cavernoma can cause a stroke. This may lead to long-term brain damage or death.
In the UK, around 100 adults are newly diagnosed with a stroke from a cavernoma each year.
There are two treatments for a cavernoma. These are brain surgery or focused radiation. However, only one in five people with cavernoma have these treatments.
A small pilot study of these treatments, called CARE, showed many people would have preferred a medicine instead of radiation or surgery.
First large-scale study of aspirin
Aspirin is a common medicine used to stop blood clots. It has the potential to prevent some cavernoma bleeds.
In the past, people with cavernoma were often advised to avoid blood thinners, such as aspirin. However, research has shown that people already taking aspirin for other conditions had a lower risk of bleeding from their cavernoma than people not taking blood thinners.
These findings have not yet been investigated in a randomised clinical trial. CARE-Aspirin will be the first large and reliable study to find out whether aspirin benefits people with brain cavernoma.
The study brings together leading institutions, researchers and patients. It will address a critical gap in the treatment of cavernoma.
Working with patients
CARE-Aspirin will be launched at the 100th anniversary of the creation of the Society of British Neurological Surgeons (SBNS). This will take place in London on 14th October.
Professor Diederik Bulters is a Consultant Neurosurgeon at UHS. He is also Professor of Neurosurgery at the University of Southampton.
He said: “On this 100th anniversary of the SBNS, the launch of CARE-Aspirin is another major landmark in the multidisciplinary collaboration between neurosurgeons, neurologists, methodologists, and – most importantly – patients.”
The study has been designed in collaboration with the patient support organisation Cavernoma Alliance UK. They will also help to deliver the study.
The Edinburgh Clinical Trials Unit further strengthens this partnership, by bringing expertise in trial design and conduct.
Professor Rustam Al-Shahi Salman is CARE-Aspirin Chief Investigator. He is Professor of Clinical Neurology and Honorary Consultant Neurologist at the University of Edinburgh.
“This clinical trial is the culmination of more than 25 years of research into brain cavernoma in Scotland. It’s a privilege to be leading such a great team that will be overseen by international experts.
“The rationale for aspirin is strong, so I hope that our partnership with Cavernoma Alliance UK will enable 392 people to take part.”
CARE-Aspirin is funded by a UKRI Medical Research Council (MRC) and National Institute for Health and Care Research (NIHR) partnership.
Victoria Wareham, Chief Executive Cavernoma Alliance UK, said:
“The launch of CARE-Aspirin marks an important milestone for the cavernoma community in the UK and beyond.
“For years, people affected by cavernoma have had limited treatment options, making research into potential treatments particularly important.
“While we don’t yet know what the trial will show, we are incredibly proud to be working in partnership to support its design and delivery. In particular, we are committed to ensuring that the voices and experiences of those living with cavernoma are at the heart of the study.”