CClinicalTrials.gg
Status unknownNCT02744937Updated Apr 20, 2016

Continuing Low Dose Aspirin Before Prostate Biopsy

A Phase 4 interventional study of Aspirin in Complication, sponsored by National Taiwan University Hospital. Status unknown. Open to male participants aged 40 Years and older. Per ClinicalTrials.gov, last updated 2016-04-20.

Sponsored by National Taiwan University Hospital · Phase 4, Interventional, and Diagnostic

The sponsor has not verified this record recently (last verified Apr 2016), so the status shown — last known as Not yet recruiting — may be out of date.
Phase
Phase 4
Study type
Interventional
Enrollment
150
Allocation
Randomized
Ages
40 Years and older
Sex
Male
01

Study summary

Objectives: To determine whether TRUS-guided prostate biopsy performed in patients continuing low-dose aspirin (LDA) is associated with a greater incidence, duration, and severity of bleeding complications.

Eligibility: Men over 40-year-old with an elevated serum prostate-specific antigen level and/or abnormal digital rectal examination findings are candidates for PB.

Design of trial Prospective Randomized Trial Study treatment: Continuing low-Dose aspirin before transrectal prostate biopsy Primary endpoint: The incidence, duration, and severity of bleeding complications Statistical analysis and sample size estimation: Fisher's exact test or chi-square test will be used to explore the differences between two groups for categorical variables, and Student t-test will be used for continuous variables. Under the assumption of a difference of 25% of bleeding complications in each group, with α=0.05 and power=0.80, 60 subject are needed in each arm. Assuming the drop-out rate to be 20%, the targeted recruit number is 150 in total.

Read the detailed description

Transrectal ultrasound (TRUS)-guided prostate biopsy (PB) is currently the standard for diagnosing prostate cancer and is one of the most commonly performed urologic procedures.

The complications that can occur after this procedure have been extensively described previously. Bleeding complications, namely hematuria, rectal bleeding, and hematospermia, are the most frequent, with a reported incidence of 20% to 70%, but they are almost exclusively self-limiting and of mild to moderate severity.

There is an increasing number of patients who require PB and antiplatelet medication simultaneously. This is because more middle-age and elderly patients are receiving long-term antithrombotic therapy mainly for prevention of cardiovascular events, and these patients form the majority of those at risk of prostate cancer. As with other surgical interventions, aspirin is typically discontinued 7 to 10 days before PB. However, discontinuing aspirin might increase the risk of cardiovascular events, while continuing aspirin before PB might not necessarily increase severe bleeding complications. Several studies have found no increase in bleeding complications in patients continuing low-dose aspirin. However, most of the studies were retrospective, and only one was randomized. Moreover, there has been no prospective randomized trial in East Asian patients, who have a lower risk of thrombosis and increased risk of bleeding during antithrombotic treatment for acute coronary syndrome than do white patients.

The aim of the present randomized study was to determine whether TRUS-guided PB performed in patients continuing low-dose aspirin (LDA) is associated with a greater incidence, duration, and severity of bleeding complications.

02

Conditions studied

  • Complication
03

In context

Lead sponsor

National Taiwan University Hospital is the lead sponsor of 2,563 studies on the registry; 569 are open to participants now.

Of its 11 completed or terminated interventional studies of FDA-regulated products, 2 (18%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
40 Years and older
Sexes eligible
Male
Accepts healthy volunteers
No

Inclusion criteria

The inclusion criteria are use of LDA (100 mg once daily) for primary prevention of cardiovascular disease and not at a high risk of cardiovascular event. The definition of high risk includes #1-7 of the following exclusion criteria or unsuitable conditions by clinical judgement.

Exclusion criteria

Exclusion Criteria:

  1. Angina in the past 3 months
  2. Exertional dyspnea on walking or climbing stairs for one floor
  3. Stroke in the past 6 months
  4. Coronary catheterization in the past 6 months
  5. Left main disease or 3-vessel disease
  6. Prior coronary arterial bypass graft surgery
  7. Use of dual (or more) antiplatelet agents
  8. Coagulopathy or diseases with bleeding tendency
  9. Hemorrhoid, anal or rectal diseases
  10. History of urinary stone or tumor
05

Study design

Phase
Phase 4
Primary purpose
Diagnostic
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Care provider)
Enrollment
150 participants (estimated)

Study arms

  • Experimental
    A

    continuing LDA

    Drug: Aspirin

  • No intervention
    B

    discontinuing LDA

Interventions

  • DrugAspirin

    aspirin is continued by its regular dosing

06

What researchers measure

Primary outcomes

  1. Compications

    To determine whether the incidence, duration, and severity of bleeding complications after transrectal prostate biopsy (PB) in patients not discontinuing low-dose aspirin (LDA) are greater than in those discontinuing it.

    Time frame: 3 weeks

07

Study locations

No study locations are listed for this record.

08

References and documents

Publications

  • Maan Z, Cutting CW, Patel U, Kerry S, Pietrzak P, Perry MJ, Kirby RS. Morbidity of transrectal ultrasonography-guided prostate biopsies in patients after the continued use of low-dose aspirin. BJU Int. 2003 Jun;91(9):798-800. doi: 10.1046/j.1464-410x.2003.04238.x. PubMed 12780835 ↗
  • Berger AP, Gozzi C, Steiner H, Frauscher F, Varkarakis J, Rogatsch H, Bartsch G, Horninger W. Complication rate of transrectal ultrasound guided prostate biopsy: a comparison among 3 protocols with 6, 10 and 15 cores. J Urol. 2004 Apr;171(4):1478-80; discussion 1480-1. doi: 10.1097/01.ju.0000116449.01186.f7. PubMed 15017202 ↗
  • Ihezue CU, Smart J, Dewbury KC, Mehta R, Burgess L. Biopsy of the prostate guided by transrectal ultrasound: relation between warfarin use and incidence of bleeding complications. Clin Radiol. 2005 Apr;60(4):459-63; discussion 457-8. doi: 10.1016/j.crad.2004.10.014. PubMed 15767103 ↗
  • Chiang IN, Chang SJ, Pu YS, Huang KH, Yu HJ, Huang CY. Major complications and associated risk factors of transrectal ultrasound guided prostate needle biopsy: a retrospective study of 1875 cases in taiwan. J Formos Med Assoc. 2007 Nov;106(11):929-34. doi: 10.1016/S0929-6646(08)60063-7. PubMed 18063514 ↗
  • Ehrlich Y, Yossepowitch O, Margel D, Lask D, Livne PM, Baniel J. Early initiation of aspirin after prostate and transurethral bladder surgeries is not associated with increased incidence of postoperative bleeding: a prospective, randomized trial. J Urol. 2007 Aug;178(2):524-8; discussion 528. doi: 10.1016/j.juro.2007.03.134. Epub 2007 Jun 14. PubMed 17570430 ↗
  • Giannarini G, Mogorovich A, Valent F, Morelli G, De Maria M, Manassero F, Barbone F, Selli C. Continuing or discontinuing low-dose aspirin before transrectal prostate biopsy: results of a prospective randomized trial. Urology. 2007 Sep;70(3):501-5. doi: 10.1016/j.urology.2007.04.016. Epub 2007 Aug 3. PubMed 17688919 ↗
  • Ecke TH, Gunia S, Bartel P, Hallmann S, Koch S, Ruttloff J. Complications and risk factors of transrectal ultrasound guided needle biopsies of the prostate evaluated by questionnaire. Urol Oncol. 2008 Sep-Oct;26(5):474-8. doi: 10.1016/j.urolonc.2007.12.003. Epub 2008 Mar 4. PubMed 18367116 ↗
  • Halliwell OT, Yadegafar G, Lane C, Dewbury KC. Transrectal ultrasound-guided biopsy of the prostate: aspirin increases the incidence of minor bleeding complications. Clin Radiol. 2008 May;63(5):557-61. doi: 10.1016/j.crad.2007.09.014. Epub 2008 Jan 11. PubMed 18374720 ↗
  • Carmignani L, Picozzi S, Bozzini G, Negri E, Ricci C, Gaeta M, Pavesi M. Transrectal ultrasound-guided prostate biopsies in patients taking aspirin for cardiovascular disease: A meta-analysis. Transfus Apher Sci. 2011 Dec;45(3):275-80. doi: 10.1016/j.transci.2011.10.008. Epub 2011 Oct 24. PubMed 22030310 ↗
  • Chowdhury R, Abbas A, Idriz S, Hoy A, Rutherford EE, Smart JM. Should warfarin or aspirin be stopped prior to prostate biopsy? An analysis of bleeding complications related to increasing sample number regimes. Clin Radiol. 2012 Dec;67(12):e64-70. doi: 10.1016/j.crad.2012.08.005. Epub 2012 Sep 7. PubMed 22959852 ↗
  • Raheem OA, Casey RG, Galvin DJ, Manecksha RP, Varadaraj H, McDermott T, Grainger R, Lynch TH. Discontinuation of anticoagulant or antiplatelet therapy for transrectal ultrasound-guided prostate biopsies: a single-center experience. Korean J Urol. 2012 Apr;53(4):234-9. doi: 10.4111/kju.2012.53.4.234. Epub 2012 Apr 18. PubMed 22536465 ↗
  • Wang J, Zhang C, Tan G, Chen W, Yang B, Tan D. Risk of bleeding complications after preoperative antiplatelet withdrawal versus continuing antiplatelet drugs during transurethral resection of the prostate and prostate puncture biopsy: a systematic review and meta-analysis. Urol Int. 2012;89(4):433-8. doi: 10.1159/000343733. Epub 2012 Nov 13. PubMed 23154789 ↗
  • Culkin DJ, Exaire EJ, Green D, Soloway MS, Gross AJ, Desai MR, White JR, Lightner DJ. Anticoagulation and antiplatelet therapy in urological practice: ICUD/AUA review paper. J Urol. 2014 Oct;192(4):1026-34. doi: 10.1016/j.juro.2014.04.103. Epub 2014 May 21. PubMed 24859439 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 20, 2016, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT02744937
Lead sponsor
National Taiwan University Hospital
Responsible party
National Taiwan University Hospital (V.S., National Taiwan University Hospital) — Principal investigator
First posted
Apr 20, 2016
Start date
Apr 2016
Primary completion
Mar 2019 (estimated)
Last update
Apr 20, 2016

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is status unknown, as verified in Apr 2016. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion