Summary
Aspirin has reached the approved stage (maximum clinical phase 4) for at least one indication, so its use in Stroke (Ischaemic / Cerebrovascular Disease) would be drug repurposing rather than first-in-human development. This does not mean it is approved for Stroke (Ischaemic / Cerebrovascular Disease). ClinicalTrials.gov lists 8 registered trials linking Aspirin to Stroke (Ischaemic / Cerebrovascular Disease): 2 are currently recruiting; 1 is active or not yet recruiting; 4 have completed; 1 is terminated, withdrawn, suspended or of unknown status. The most advanced is Phase 4 (NCT00966316). The largest enrolment is 1446 participants (NCT05507645). Registration activity spans 2008 to 2026. The literature layer holds 14 publications for this pair: 5 Cochrane reviews, 2 meta-analyses, 2 systematic reviews and 5 clinical trial publications. Publication years run from 2025 to 2026. Because at least one synthesis-level source exists (systematic review, meta-analysis or Cochrane review), this pair has been assessed beyond single studies, although the synthesis may concern a different indication.
The RepurpOS disease-intelligence file for Ischemic Stroke ranks 577 candidate therapeutics from Open Targets, ChEMBL, DGIdb and PubMed; only a minority carry direct clinical evidence, and this page covers one of those. Spontaneous remission context recorded for the condition: Spontaneous early neurological improvement in 10-20% within 24 hours of ischaemic stroke without intervention; functional independence at 3 months in only 40-50% without revascularisation; 15% 30-day mortality untreated.
Evidence table
| Evidence tier | A · Strong |
|---|---|
| Evidence score | 77.0 (trials 27.0, literature 30.0, tier 15, approved bonus 5.0) |
| Registered trials | 8 total: 2 recruiting, 1 active / not yet recruiting, 4 completed, 1 other |
| Linked publications | 14 (5 Cochrane reviews, 5 clinical trial publications, 2 meta-analyses, 2 systematic reviews) |
| Agent type | Drug (Small molecule) |
| Development stage (any indication) | Approved |
| Mechanism / class | Not recorded |
| Data sources | Open Targets, ChEMBL |
How the evidence score is calculated
- Each registered trial scores by status (recruiting / active / enrolling 3, completed 2.5, not yet recruiting 2, unknown 1, terminated / withdrawn / suspended 0.5) plus a phase bonus (phase 3-4 +2, phase 2 +1, phase 1 +0.5). The trial component is capped at 30.
- Each literature item scores by design (Cochrane review 5, meta-analysis 4, systematic review 3, RCT 3, clinical trial publication 2, curated reference 1.5, other PubMed record 1). The literature component is capped at 30.
- The existing evidence tier adds 15 (A / Strong), 10 (B / Moderate), 5 (C / Preliminary) or 0 (D / Anecdotal).
- Agents approved for any indication (max clinical phase 4) add 5, because an approved agent has an established safety profile that lowers the barrier to repurposing trials.
- The score ranks what has been studied, not what works. It does not read effect sizes or directions of effect.
Registered clinical trials
| NCT ID | Title | Status | Phase | Enrolment |
|---|---|---|---|---|
| NCT00966316 | Establishment and Evaluation to the Effects of a Clinical Pathway for Acute Ischemic Stroke 2009 | completed | Phase 4 | 314 |
| NCT06316570 | Ticagrelor With Aspirin Dual Antiplatelet Therapy Combined With Intravenous Thrombolysis for Ischemic Stroke 2024 | completed | Phase 3 | 1,382 |
| NCT05507645 | ProUrokinase for Mild Ischemic Cerebrovascular Events (PUMICE) 2022 | completed | Phase 3 | 1,446 |
| NCT06591377 | Combining Aspirin With Ticagrelor or Cilostazol in Large-vessel Minor Stroke or TIA 2024 | recruiting | Phase 3 | 900 |
| NCT03186456 | The Safety and Efficacy of Human Umbilical Cord Mesenchymal Stem Cells (19#iSCLife®-ACI) in the Treatment of Acute Cerebral Infarction 2026 | suspended | Phase 1 | 40 |
| NCT00691314 | Efficacy and Safety of Stent Implantation in Symptomatic Extra- and Intracranial Artery Stenosis 2008 | completed | Not applicable | 300 |
| NCT06683300 | Drug Eluting Stenting and Short Dual Antiplatelet Therapy for Preventing Recurrent Stroke in Vertebral Stenosis Registry Study 2024 | not yet recruiting | Not applicable | 520 |
| NCT06899399 | Efficacy and Safety Study of Endovascular Treatment of Asymptomatic Carotid Artery Stenosis 2024 | recruiting | Not applicable | 982 |
Published literature
- Clinical trial publication Dual Antiplatelet Therapy and Immediate Intensive Statin in Mild Ischemic Stroke: A Randomized TrialPan Y, Gao Y, Chen W et al. · Neurology · 2026 · PMID 42348803
- Clinical trial publication The effect of dose of aspirin in high-risk TIA and minor ischemic stroke patients receiving dual antiplatelet medicationQureshi AI, Huang Y, Ranjini NJ et al. · Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2026 · PMID 42150677
- Clinical trial publication Ticagrelor with aspirin dual antiplatelet therapy combined with intravenous thrombolysis in patients with ischaemic stroke in China (TAPIS): a multicentre, double-blind, randomised controlled trialWang A, Xia X, Tang Y et al. · Lancet (London, England) · 2026 · PMID 42114550
- Clinical trial publication Intravenous Tirofiban After Tenecteplase in Acute Ischemic Stroke: The INSTANT Randomized Clinical TrialINSTANT Trial Authors for the INSTANT Investigators, Liu X, Zhang F et al. · JAMA · 2026 · PMID 42100960
- Clinical trial publication Polygenic Risk Identifies Older Adults Who May Benefit From Aspirin for the Primary Prevention of Ischemic StrokeYu C, Hussain SM, Fransquet PD et al. · Stroke · 2026 · PMID 42100829
- Cochrane review Optimal duration of dual antiplatelet therapy for secondary stroke prevention: A systematic review and meta-analysisOliveira Filho ARDS, de Oliveira Souza NV, Oliveira DM et al. · Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2026 · PMID 42218849
- Cochrane review Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) for preventing colorectal cancer and colorectal adenoma in the general populationCai Z, Meng Y, Yang W et al. · The Cochrane database of systematic reviews · 2026 · PMID 41919561
- Cochrane review Efficacy, Safety, and Net Clinical Benefit of Post-Atrial Fibrillation Ablation AnticoagulationAbomohsen M, Mohamed AE, Almakadma AH et al. · Pacing and clinical electrophysiology : PACE · 2026 · PMID 41889075
- Cochrane review Impact of dual antiplatelet therapy within 72 hours post mild ischemic stroke and transient ischemic attack: meta-analysisXie J · Brain injury · 2026 · PMID 41251253
- Meta-analysis Safety and efficacy of ticagrelor plus aspirin vs. aspirin monotherapy in patients undergoing coronary artery bypass grafting: A meta-analysis with trial sequential analysisHammadeh BM, Hussein AM, Alhamwi N et al. · Journal of thrombosis and thrombolysis · 2026 · PMID 41917648
- Meta-analysis Antiplatelet dilemma: Clopidogrel or aspirin for long-term cardiovascular protection after dual antiplatelet therapy following PCIMoawad MHED, Elsayed M, Serag I et al. · Medicine · 2026 · PMID 41760043
- Systematic review Switching From Aspirin Monotherapy After Noncardioembolic Stroke: A Systematic Review and Network Meta-AnalysisRothstein A, Khazaal O, Messe SR et al. · Stroke · 2026 · PMID 41347302
- Cochrane review Aspirin plus clopidogrel versus aspirin alone in patients with mild-to-moderate stroke: A systematic review and meta-analysisAhmed M, Nadeem ZA, Ahsan A et al. · Medicine · 2025 · PMID 41465965
- Systematic review Effectiveness and safety of different antiplatelet therapies for minor ischemic stroke or high-risk transient ischemic attack: a systematic review and network meta-analysisJin T, Jiang H, Chen G et al. · International journal of clinical pharmacy · 2025 · PMID 41118059
Mechanism and notes
No mechanism of action is recorded for this pair in the source databases.
OSMF's existing evidence tier for this pair is A (Strong), derived from the strength of the disease association recorded in Open Targets and ChEMBL. The tier describes how well the drug-disease link is documented, not how well the drug works.
Frequently asked questions
Is Aspirin approved for Stroke (Ischaemic / Cerebrovascular Disease)?
Aspirin has reached the approved stage (maximum clinical phase 4) for at least one indication, so its use in Stroke (Ischaemic / Cerebrovascular Disease) would be drug repurposing rather than first-in-human development. This does not mean it is approved for Stroke (Ischaemic / Cerebrovascular Disease). Approval status for the specific indication should always be confirmed with the relevant regulator and prescribing information.
Is Aspirin in clinical trials for Stroke (Ischaemic / Cerebrovascular Disease)?
ClinicalTrials.gov lists 8 registered trials linking Aspirin to Stroke (Ischaemic / Cerebrovascular Disease): 2 are currently recruiting; 1 is active or not yet recruiting; 4 have completed; 1 is terminated, withdrawn, suspended or of unknown status. The most advanced is Phase 4 (NCT00966316). The largest enrolment is 1446 participants (NCT05507645). Registration activity spans 2008 to 2026.
What does the evidence show for Aspirin in Stroke (Ischaemic / Cerebrovascular Disease)?
Aspirin has both completed registered trials and synthesis-level publications linked to Stroke (Ischaemic / Cerebrovascular Disease). That is the strongest profile in this database, but the summaries here do not extract effect sizes, so read the linked reviews for direction and magnitude of benefit. OSMF's existing evidence tier for this pair is A (Strong), derived from the strength of the disease association recorded in Open Targets and ChEMBL. The tier describes how well the drug-disease link is documented, not how well the drug works.
Cite this page
Data: ClinicalTrials.gov, PubMed, Open Targets, ChEMBL, DGIdb and the OSMF therapeutic agent database. Last updated 2026-07-05. Page built 2026-10-07.