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Prasugrel: a guide to its use in patients with acute coronary syndromes undergoing percutaneous coronary intervention in the US
American Journal of Cardiovascular Drugs, 06/01/2012
Clinical Article
Lyseng–Williamson KA – Limited pharmacoeconomic analyses suggest that prasugrel–based therapy is an economically attractive treatment strategy relative to clopidogrel–based therapy from a US healthcare payer perspective.
- Oral prasugrel (Effient; Efient) provides rapid, potent inhibition of platelet aggregation.
- It is indicated (in combination with aspirin) for the prevention of atherothrombotic events in patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI).
- In the pivotal clinical trial in this patient population, prasugrel–based therapy was associated with a significantly lower incidence of ischemic events than clopidogrel–based therapy.
- However, the efficacy of prasugrel was offset by a higher risk of bleeding than clopidogrel, with patients aged ≥75 years, those weighing <60kg and those with a history of stroke or transient ischemic attack at the greatest risk.
- Prasugrel appears to have an overall favorable risk:benefit ratio in ACS patients undergoing PCI who do not have these three easily identifiable clinical characteristics.
