Some 120 years after Aspirin – the world-famous painkiller – was first introduced in 1899, it is now one of the world’s most widely-used medications, with more than 40,000 metric tonnes of this particular drug produced and distributed each year. In the first quarter of 2018 alone, sales of the drug raked in more than €109 million, representing a sizable contribution to the bottom line of Bayer, the German pharmaceutical giant that owns the licence.
Despite its ubiquity, most pill-poppers know little about their painkiller of first resort, including its actual scientific name – acetylsalicylic acid. Similarly, while they may well be aware of its anti-inflammatory, anti-pyretic and painkilling properties, they probably don’t know that its active ingredient is derived from salicin, a substance most commonly found in the bark of willow trees.
The first recorded use of salicin dates back to the Ancient Sumerians. Extant clay tablets from that time record physicians regularly prescribing this particular herbal extract to their pain-wracked patients. The Mesopotamians, the Chinese and the Greeks of classic times – and even Hippocrates (460BC- 370BC), the Greek physician famed as the father of modern medicine – were also fans.
Despite salicin having been deployed in various forms for thousands of years, it wasn’t until1828 that Johann Buchner, a professor at the University of Munich, first identified salicin as a healing agent and while also properly isolating it from willow bark. It would be the best part of another 70 years, however, before artificially-produced salicylic acid was created for the first time. Initially, it was seen as a revolutionary treatment for those with rheumatism, though prolonged use caused gastrointestinal irritation.
Even now, some 120 years on, there is some controversy as to who exactly created aspirin. A number of parties attribute it to Felix Hoffmann, a German scientist and Bayer employee. Tasked with creating a ‘better salicylic acid’, in August 1897, he synthesised a new, stable derivative by combining salicylic acid with acetic acid. This then had the advantage of creating no stomach problems, while its therapeutic benefits remained undiminished.
Quickly realising how much money could be made from Hoffmann’s compound, Bayer swiftly registered its new pharmaceutical asset, choosing ‘Aspirin’ as a suitably mass-market -friendly name for the painkiller. The treatment was soon taken up by medical establishments across the Western world, ensuring its widespread use and maximising the profit potential for Bayer.
In 1900, the pharmaceutical giant launched Aspirin in a tablet form, an innovation that proved to be a huge commercial success. In 1915, the drug became available without the need for prescription, in many respects paving the way for the mass-market pharmaceutical industry that exists today. Accordingly, in 1950, The Guinness Book of Records awarded it the accolade of the World’s Most Frequently-Purchased Painkiller.
More recently, several newer pharmaceutical innovations – notably the mid-20th century arrival of Ibuprofen and Panadol – proved a challenge to its supremacy, with the more efficient delivery systems of the newcomers seemingly set to oust it from all-but-obligatory use. Just as Aspirin seemed destined for the healer history books, however, research in the ’60s soundly uncovered an unexpectedly wide range of new applications for the drug.
This reinvention was triggered by the ground-breaking work of two US physicians – Harvey Weiss and Louis Aledort. In 1967, they published a research paper that showed the active ingredients in Aspirin could reduce the likelihood of blood clots, a huge boon for patients with cardiopulmonary problems and, in particular, heart attack and stroke victims.
Building on this, in 1978, another landmark Aspirin drug trial – this time conducted by The Canadian Cooperative Study – showed that, among patients who had already undergone a major cardiac event (such as a stroke or a heart attack), a daily dose of Aspirin could significantly reduce the risk of a second such incident by as much as 31 percent – a huge figure.
Since then, there have been countless studies focussing on the potential benefits of Aspirin across an array of different medical scenarios. Astonishingly, there may still be far more to learn about just what Aspirin can do. Indeed, it does seem that researchers are uncovering previously unthought-of benefits of the drug every year. In line with this, a recent study indicated that regularly taking Aspirin could substantially reduce the risk of certain cancers, most notably bowel (colorectal) cancer. To put this into perspective, this is the third most-common cause of oncological deaths in the US, with the US Preventive Services Task Force – an independent body of national medical experts – now suggesting that Aspirin could reduce the risk represented by this particular cancer by up to 40 percent.
Though its effects are unambiguously beneficial, medical professionals remain at a loss to explain why Aspirin is proving just such a panacea. Some 120 years after its effectiveness was first scientifically anointed, it continues to startle with its – apparently – never-ending medical applications. It could well be that we will still be discovering new therapeutic benefits for decades to come.
Text: Tenzing Thondup
Photos: AFP