New study to test whether aspirin benefits people with brain cavernoma

Doctors and researchers at the University of Edinburgh and the University Hospital Southampton will lead a new £3.5M UK-wide clinical study, called CARE-Aspirin, looking at whether aspirin benefits people with cavernoma.

The study, Cavernous malformations of the brain: A Randomised Efficacy study of aspirin versus placebo, has been designed in collaboration with the patient support organisation Cavernoma Alliance UK, who will also help deliver the study. CARE-Aspirin is funded by a UKRI Medical Research Council (MRC) and National Institute for Health and Care Research (NIHR) partnership. The study will evaluate whether:

aspirin prevents stroke due to cavernoma better than placebo,
aspirin changes the size or look of cavernomas.

This innovative, multidisciplinary project brings together leading institutions, researchers and patients to address a critical gap in the treatment of cavernoma. A cavernoma is a small group of blood vessels in the brain that behave differently from normal blood vessels. Most people with cavernoma will have no symptoms. However, clotting or bleeding in the cavernoma can cause a stroke, which may lead to long-term 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, brain surgery or focused radiation, but only 1 in 5 people with cavernoma has these treatments. A small pilot study of these treatments, called CARE, showed that many people would have preferred a medicine instead of radiation or surgery.

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.

Aspirin is a common medicine used to stop blood clots and might prevent some cavernoma bleeds. In the past, people with cavernoma were often advised to avoid blood thinners, such as aspirin. However, aspirin seems safe because 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.

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 led jointly by Professor Rustam Al-Shahi Salman of the University of Edinburgh and Professor Diederik Bulters of the University Hospital Southampton NHS Foundation Trust, in partnership with Cavernoma Alliance UK. The Edinburgh Clinical Trials Unit further strengthens this partnership by bringing expertise in trial design and conduct.

Edinburgh Clinical Trials Unit is delighted to support the design and delivery of the CARE-Aspirin trial. This collaborative research will address important questions in the treatment of cavernoma, providing valuable evidence to inform patients and clinical practice.

CARE-Aspirin is being launched at the 100^th anniversary of the creation of the Society of British Neurological Surgeons in London on 14 October 2026

On this 100^th 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.

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