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Published on: January 18, 2017

Does aspirin worsen Crohn's disease outcomes? A multicenter propensity-matched cohort study

Kojo-Frimpong B Awuah1, Komlan Guedze2, Somtochukwu Onwuzo3

  • 1Department of Internal Medicine, Allegheny Health Network, Pittsburgh, Pennsylvania, USA.

Proceedings (Baylor University. Medical Center)
|May 18, 2026
PubMed

Insights

Aspirin use in Crohn's disease (CD) patients is linked to higher mortality and increased intestinal issues like exacerbations and toxic megacolon. Careful consideration is needed for prescribing aspirin to individuals with CD.

Area of Science:

  • Gastroenterology
  • Clinical Pharmacology

Background:

  • Crohn's disease (CD) involves chronic gut inflammation and impaired healing, potentially increasing susceptibility to aspirin's adverse effects.
  • The safety of aspirin for cardiovascular prevention in CD patients remains uncertain.
  • This study investigates aspirin's impact on major clinical outcomes in a large Crohn's disease cohort.

Purpose of the Study:

  • To evaluate the association between aspirin use and significant clinical outcomes in adults with Crohn's disease.
  • To determine if aspirin use affects mortality, disease flares, or specific gastrointestinal complications in CD patients.

Main Methods:

  • A large cohort of adults with Crohn's disease was analyzed using the TriNetX Network.
  • Aspirin users were propensity score-matched 1:1 with nonusers based on demographics, comorbidities, and CD severity.
  • Primary outcome was all-cause mortality; secondary outcomes included CD exacerbations, bowel obstruction, fistula, abscess, toxic megacolon, colorectal cancer, and colectomy.

Main Results:

  • Aspirin use was associated with a 23% increase in all-cause mortality (RR 1.23) and a 93% increase in CD exacerbations (RR 1.93).
  • Elevated risks were observed for intestinal abscess (RR 1.32) and toxic megacolon (RR 1.87) in aspirin users.
  • No significant differences in colorectal cancer incidence or colectomy rates were found between aspirin users and nonusers.

Conclusions:

  • Aspirin use in patients with Crohn's disease is linked to increased mortality and intestinal morbidity.
  • These findings highlight the importance of individualized risk-benefit assessments for prescribing aspirin in CD patients.
  • Further research may be warranted to explore mechanisms and alternative strategies for cardiovascular prevention in this population.
Abstract

Keywords:
AspirinCrohn’s diseaseexacerbationinflammatory bowel diseasetoxic megacolon

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