Meta-analysis of direct and indirect comparison of ticagrelor and prasugrel effects on platelet reactivity

The American Journal of Cardiology
T LhermusierRon Waksman

Abstract

Studies have linked on-treatment platelet reactivity (PR) to adverse clinical outcomes. Because new P2Y12 inhibitors (prasugrel and ticagrelor) have been predominantly tested against clopidogrel, data on pharmacodynamic comparisons between these 2 drugs are scarce. We compared ticagrelor with prasugrel in a network meta-analysis. PubMed, Cochrane, and EMBASE were searched for studies assessing PR in patients with coronary artery disease treated with ticagrelor or prasugrel. All studies using prasugrel and/or ticagrelor providing platelet function measurement data using VerifyNow P2Y12 reaction units (PRUs), platelet reactivity index (PRI) vasodilator-stimulated phosphoprotein phosphorylation, or maximal platelet aggregation (MPA) by light transmission aggregometry were considered eligible. Mixed treatment comparison models directly compared ticagrelor and prasugrel and indirectly compared them using clopidogrel as a comparator with data presented as mean difference (95% confidence interval). Data were extracted from 29 studies, including 5,395 patients. Compared with clopidogrel 75 mg, both prasugrel 10 mg and ticagrelor 90 mg twice daily were associated with lower PRU (mean difference -117 [-134.1, -100.5] and -159.7 [-182.6, ...Continue Reading

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Citations

Mar 26, 2016·JACC. Cardiovascular Interventions·Francesco FranchiDominick J Angiolillo
May 18, 2016·European Heart Journal·Marco Cattaneo
May 31, 2015·Cardiovascular Diabetology·Dimitrios AlexopoulosIoanna Xanthopoulou
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Nov 24, 2018·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·Yueh-Chung ChenChien-Sung Tsai
Oct 3, 2017·Coronary Artery Disease·Hengliang ZhangYanyun Li
Mar 18, 2019·BMJ Open·Gonçalo Silva DuarteDaniel Caldeira
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Nov 21, 2020·Journal of the American College of Cardiology·Christian ValinaAdnan Kastrati

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