Pharmacodynamic effects of prasugrel dosing regimens in patients on maintenance prasugrel therapy: results of a prospective randomized study

Journal of the American College of Cardiology
Antonio Tello-MontoliuDominick J Angiolillo

Abstract

The purpose of this study is to assess the pharmacodynamic effects of different prasugrel dosing regimens in patients on maintenance prasugrel therapy. There are a growing number of patients on chronic prasugrel therapy regimens, leading to questions about the dosing regimen of prasugrel to administer if percutaneous coronary intervention is required. This is a prospective pharmacodynamic study in patients (n = 64) receiving maintenance prasugrel therapy who were randomly allocated to a 10 mg, 30 mg, or 60 mg dose of prasugrel. Pharmacodynamic assessments using multiple assays were conducted at 3 timepoints (baseline and 1 h and 4 h after dosing). Intragroup comparisons showed that a 60 mg dose reduced the platelet reactivity index (PRI) after 1 h (p = 0.004) and 4 h (p < 0.001, primary endpoint; p = 0.002 between 1 h and 4 h). A 30 mg dose also reduced PRI levels at 1 h (p = 0.006) and 4 h (p < 0.001; p = 0.044 between 1 h and 4 h). A 10 mg dose was associated with modest pharmacodynamic effects. Intragroup comparisons showed similar findings with VerifyNow-P2Y12 and light transmission aggregometry. Intergroup comparisons showed that a 60 mg dose achieved lower PRI levels than 30 mg at 4 h (p = 0.05), and a numerical trend tow...Continue Reading

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References

Nov 6, 2007·The New England Journal of Medicine·Stephen D WiviottUNKNOWN TRITON-TIMI 38 Investigators
Mar 4, 2010·Circulation Journal : Official Journal of the Japanese Circulation Society·Dominick J AngiolilloShinya Goto
Sep 11, 2010·Journal of the American College of Cardiology·Laurent BonelloUNKNOWN Working Group on High On-Treatment Platelet Reactivity

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Citations

Apr 16, 2013·Journal of Thrombosis and Thrombolysis·Wei Eric WangChunyu Zeng
Jan 19, 2013·Journal of the American College of Cardiology·Anthony N DeMariaSotirios Tsimikas
Aug 5, 2017·Current Treatment Options in Cardiovascular Medicine·Abhishek SinhaRahul Sakhuja

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