Platelet Inhibitor No Match for Plavix

Effient does not perform as well as Plavix in improving outcomes after heart attacks

/ Author:  / Reviewed by: Chris Galloway, M.D.

(RxWiki News) Doctors are always looking to help patients with the latest technology and newest medications. But sometimes, the tried and true method may be the best way to go for heart attack patients.

A platelet-inhibiting drug has not been found to perform as well as clopidogrel (Plavix) in improving outcomes for high-risk patients that have experienced heart attacks or have chest pain that could lead to a heart attack.

The platelet inhibitor prasugrel" data-scaytid="4">prasugrel (Effient)was approved by the U.S. Food and Drug Administration in 2009 to reduce heart events in individuals with acute coronary syndrome (ACS), a group of symptoms associated with obstruction of coronary arteries.

"Discuss lowering heart risks with your cardiologist."

Matthew T. Roe, MD, MHS, lead researcher and an associate professor of medicine from Duke University School of Medicine, found that when combined with low-dose aspirin, Effient did not offer a significant reduction in the rate of heart attacks, stroke or cardiovascular-related death as compared to Plavix.

Researchers had originally suspected the more aggressive anti-platelet therapy may further reduce recurrent cardiovascular risk.

During the double-blind randomized TRILOGY ACS trial investigators followed 7,243 patients who had previously had a heart attack or who suffered from unstable angina, a type of chest pain that may lead to a heart attack. The participants were all under the age of 75 and also took aspirin.

They were followed for up to 30-months after being assigned to take either 10 daily milligrams of Effient or 75 milligrams a day of Plavix. In a secondary analysis of 2,083 patients over the age of 75, participants were asked to take either 5 milligrams of Effient or 75 milligrams of Plavix each day.

After 17 months of follow up, 14 percent of patients under the age of 75 taking Effient had suffered a heart attack, stroke or cardiovascular death compared to 16 percent of Plavix patients. Findings among older patients was similar.

Patients taking Plavix were slightly more likely to experience heart failure, but the risk of adverse events including serious bleeding was similar among both groups.

The research was funded by pharmaceutical companies Eli Lilly and Daiichi Sankyo. Together the companies market Effient.

The study was recently published in the New England Journal of Medicine.

Reviewed by: 
Review Date: 
August 27, 2012
Last Updated:
August 29, 2012