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

Acetylsalicylic acid (ASA) is commonly used as a non-steroidal anti-inflammatory drug that interferes with multiple biological pathways. ASA acts by stimulating osteogenesis and inhibiting osteoclastogenesis. 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 the bone regeneration in animal models. This review was structured based on the PRISMA Statement and registered on PROSPERO database according to protocol number #CDR42018111403. The quality of evidence was assessed by using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE). With the development of search strategies, we identified studies on the use of ASA from the following databases: 1- Medline (via PubMed); 2 - Web of Science; 3 - Scopus; and 4 - EMBASE. A total of 296 articles were identified and after screening the title, abstract, and full text, only 18 studies were selected for qualitative analysis and 12 were selected for performance of the quantitative analysis (meta-analysis). A meta-analysis of the amount of bone tissue formed showed a significant advantage when ASA was locally used, revealing a mean difference (MD) of 22.75% (95% CI: 15.39-30.12) p < 0.00001. Within the limitations of the available data, the results were promising and showed that ASA can be effective in bone formation in animal models.