Prodrugs Effient and Plavix to compete

The FDA approved the drug prasugrel on July 10. The drug is made by Lilly and was discovered by a Japanese company Daiichi Sankyo. It will be called Effient. This drug will compete head-to-head with Plavix, which will go off patent in 2011 and become generic.These drugs both act on platelets to block the P2Y12 receptor so that platelets can not activate and bind together to form clots. Their primary use is in the treatment of patients who have coronary stents and, in particular, drug eluting stents.

In several major studies in which we participated, Effient was found to be more potent than Plavix. What this means is that the antiplatelet effect is stronger for Effient so that there was a significant decrease in the endpoints of death from cardiovascular causes, nonfatal myocardial infarction or nonfatal stroke (9.9% vs.12.1%). More than 13,000 patients participated. The flip side is that there is an increased risk of important bleeding with the drug because, basically, it works better.

Plavix and Effient are both prodrugs. Effient is more potent, has a more rapid onset of action, and a more consistent effect on platelet inhibition than Plavix. Interestingly, there is lower patient variability and fewer patients were felt to have an inadequate response when tested.

This benefit was seen within 3 days of the comparison and lasted the entire study. Most of the benefit was because of the lower myocardial infarction rate in the Effient group.

We are presently working on other P2Y12 receptor antagonists. It is very rewarding for those of us at the JMHVRI to be associated with this type of work and we wish to thank our patients who participated. Their willingness is what enables our work to continue. We are here for you. We can not work without the selfless community members who say “yes I will participate”. They have our thanks and admiration.

Tags: Coronary stents, drug-eluting stents, Effient, Platelets, Plavix, prasugrel, Prodrugs, Receptor antagonists

This entry was posted on Sunday, August 16th, 2009 at 12:32 pm and is filed under Aortic Aneurysms /Stents / Grafts, Myocardial Infarction. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.