Pharmacodynamic effects of prasugrel dosing regimens in patients on maintenance prasugrel therapy Full Text
JACC - Journal of the American College of Cardiology, 05/02/2012
Clinical Article
Tello–Montoliu A et al. – For patients on maintenance prasugrel therapy, a 60 mg dosing strategy is associated with faster and higher platelet inhibition compared with lower doses, as assessed by P2Y12 specific assays.
Methods- 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 toward better pharmacodynamic effects at 1 h (p = 0.171).
- Intergroup comparisons were similar with VerifyNow–P2Y12, but not light transmission aggregometry.
