Introduction: The use of generic drugs is continuously growing; however, there are limited epidemiological data regarding the therapeutic equivalence of each original drug formulation with its generic counterparts. We evaluated the 12-month composite endpoint of recurrent acute myocardial infarction, ischaemic stroke, cardiac deaths, or hospitalisation due to a major bleeding in acute coronary syndrome (ACS) patients treated with original clopidogrel or a generic clopidogrel formulation, in relation to sociodemographic and clinical characteristics.
Material And Methods: Consecutive Greek ACS patients ( = 1194) hospitalised in the Aegean islands and the Attica region were enrolled. Clopidogrel treatment was recorded either as original clopidogrel hydrogen sulphate (Plavix/Iscover) or as a generic clopidogrel besylate formulation (Clovelen). The composite endpoint was recorded at 12-month follow-up.
Results: The 12-month composite endpoint was 3.9% (4.6% in the Aegean islands and 3.5% in the Attica area, > 0.05). The respective incidence in men was 4.0% and in women 3.8% ( > 0.05). Overall, generic and original clopidogrel use was 87% and 13% of patients, respectively. No significant differences were observed between original and generic clopidogrel use and 12-month composite endpoint incidence. Subgroup analysis with gender, region of residence, and clinical and lifestyle factors as strata did not reveal any significant outcomes. Haemorrhage incidence did not exceed 1% in the total sample.
Conclusions: The use of a generic clopidogrel besylate formulation was quite high in both urban and insular areas of Greece and had similar efficacy and safety profile with the original clopidogrel salt, supporting the routine use of this low-cost generic clopidogrel in the management of cardiovascular disease patients.
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http://dx.doi.org/10.5114/aoms.2020.95878 | DOI Listing |
J Stroke
May 2024
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Background And Purpose: Non-high-density lipoprotein cholesterol (non-HDL-C), which represents the total cholesterol content of all pro-atherogenic lipoproteins, has recently been included as a new target for lipid-lowering therapy in high-risk atherosclerotic patients in multiple guidelines. Herein, we aimed to explore the relationship between non-HDL-C level and the efficacy and safety of ticagrelor-aspirin versus clopidogrel-aspirin in preventing stroke recurrence.
Methods: This study comprised a post hoc analysis of the CHANCE-2 (Ticagrelor or Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events II) trial, from which 5,901 patients with complete data on non-HDL-C were included and categorized by median non-HDL-C levels, using a cutoff of 3.
Thromb Res
June 2024
Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China. Electronic address:
Background And Purpose: Hypolipidemia and platelet activation play key roles in atherosclerotic diseases. Pirinixic acid (WY-14643) was originally developed as a lipid-lowering drug. Here we focused on its antiplatelet and antithrombotic abilities and the underlying mechanism.
View Article and Find Full Text PDFJ Stroke Cerebrovasc Dis
June 2024
Department of Critical Care Medicine, Shenzhen Baoan People's Hospital, Shenzhen, China. Electronic address:
Objective: This research aims to investigate the impact of individualized antiplatelet therapy guided by thromboelastography with platelet mapping (TEG-PM) on the clinical outcomes of patients with non-cardiogenic ischemic stroke.
Methods: Among a total of 1264 patients, 684 individuals diagnosed with non-cardiogenic ischemic stroke underwent TEG-PM testing. Based on the adjustment of antiplatelet medication, these patients were divided into individual and control groups.
Expert Rev Neurother
February 2024
Division of Neurointerventional Radiology, Sinai Hospital of Baltimore, LifebridgeHealth Sysyem, Baltimore, Maryland, USA.
Introduction: Prasugrel, a potent P2Y receptor inhibitor, is not currently recommended in patients with stroke due to a higher rate of recurrent stroke. Prasugrel was associated with comparable efficacy to clopidogrel in reducing the risk of ischemic stroke in a recent phase III study.
Areas Covered: The authors provide an overview of the potential role of prasugrel in the management of ischemic stroke.
EClinicalMedicine
January 2024
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Background: The atherogenicity of remnant cholesterol (RC), a contributor to residual risk of cardiovascular events, has been underlined by recent guidelines. We aimed to evaluate the relationship between RC levels and the efficacy and safety of genotype-guided dual antiplatelet therapy in the CHANCE-2 trial.
Methods: This post-hoc study used data from the CHANCE-2 trial, which was a randomised, double-blind, placebo-controlled trial of 6412 patients (aged >40 years) enrolled from 202 hospitals in China, between Sept 23, 2019, and March 22, 2021, who carried loss-of-function alleles and had either an acute minor stroke or high-risk transient ischaemic attack (TIA), and could start treatment within 24 h of symptom onset.
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