Ticagrelor as an Alternative for Clopidogrel-Associated Acute Arthritis

Case Reports in Emergency Medicine
Starr-Mar'ee C BedyGreg Flaker

Abstract

A 65-year-old Caucasian man was hospitalized for a non-ST-elevation myocardial infarction. On discharge, the patient was started on multiple new medications, including clopidogrel and atorvastatin. Twenty-six days after discharge, he presented to the Emergency Department (ED) with polyarthralgias. He was instructed to stop atorvastatin and to follow up with rheumatology and cardiology clinic. At cardiology clinic follow-up 43 days after ED discharge, clopidogrel was discontinued and patient was switched to ticagrelor. On follow-up one month later, his symptoms had completely resolved. During the next 4 months, patient had routine follow-up due to participation in Cardiopulmonary Rehab and he had no cardiac events or recurrence of joint symptoms. Our patient had no history of arthritis. Because he initially presented with 2 medication classes associated with arthritis, each was withdrawn separately. The temporal association of patient's symptomatic improvement strongly suggests that the arthritis was caused by clopidogrel. Our patient was able to tolerate ticagrelor with complete resolution of his arthritis and no cardiac events. Clopidogrel-induced arthritis is a rare adverse drug event. For patients with a recent drug-eluting ...Continue Reading

References

Jul 13, 2006·International Journal of Immunopathology and Pharmacology·A S R MuthusamyP J Friend
Jun 10, 2008·British Journal of Clinical Pharmacology·Jonathan Campion, Andrew Western
Dec 22, 2009·Rheumatology International·Shin-ya KawashiriKatsumi Eguchi
Mar 7, 2012·Pharmacotherapy·Chad J Coulter, Shari V Montandon
May 20, 2015·International Journal of Cardiology·Nixiao ZhangTong Liu
Jul 1, 2013·Journal of Investigative Medicine High Impact Case Reports·Sahil AgrawalJalaj Garg

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