Clinical profile of prasugrel, a novel thienopyridine
Prasugrel (CS-747; LY-640315) is a novel, third-generation oral thienopyridine that is a specific, irreversible antagonist of the platelet adenosine 5′-diphosphate P2Y12 receptor. Laboratory results with prasugrel support more potent antiplatelet effects, a lower incidence of interpatient variability in antiplatelet response, and a reduced time to onset of antiplatelet activity compared with clopidogrel. Phase II results indicate that prasugrel produces a greater antiplatelet effect than clopidogrel administered even at doses higher than the currently approved 300-mg loading dose and 75-mg/d maintenance dose. Recent phase III data show that prasugrel is superior to clopidogrel in preventing ischemic events in patients with acute coronary syndrome undergoing percutaneous coronary intervention, although this was associated with a greater risk of bleeding.
aDivision of Cardiology, University of Florida College of Medicine–Jacksonville, Jacksonville, FL
bDivision of Cardiology, University of Michigan, Ann Arbor, MI
Reprint requests: Dominick J. Angiolillo, MD, PhD, FACC, FESC, Division of Cardiology, University of Florida–Shands Jacksonville, 655 West 8th St, Jacksonville, FL 32209.
Conflicts of Interest: Dominick J. Angiolillo, MD, PhD, FACC, FESC has declared the following conflicts of interest: Honoraria/Lectures: Bristol Myers Squibb (New York, NY); Sanofi-Aventis (Bridgewater, NJ); Eli Lilly and Company (Indianapolis, IN); Daiichi Sankyo, Inc (Parsippany, NJ). Honoraria/Advisory board: Bristol Myers Squibb; Sanofi-Aventis; Eli Lilly Co; Daiichi Sankyo, Inc.; The Medicines Company (Parsippany, NJ); Portola (San Francisco, CA); Novartis (East Hanover, NJ). Research Grants: GlaxoSmithKline (Brentford, London, United Kingdom); Otsuka (Tokyo, Japan). Eric R. Bates, MD, FACC has declared the following conflicts of interest: Honoraria/Lectures: Sanofi-Aventis; Hoffmann-La Roche (Nutley, NJ). Honoraria/Advisory board: Eli Lilly Co; The Medicines Company; Daiichi Sankyo, Inc.; Medicure Pharma (Winnipeg, Manitoba, Canada). Research Grants: Eli Lilly and Company. Theodore A. Bass, MD, FACC has declared the following conflicts of interest: Honoraria/Lectures: Eli Lilly and Company; Daiichi Sankyo, Inc.
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