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A head-to-head trial has found that prasugrel is a more potent antiplatelet agent than clopidogrel, reducing the death rate in heart attack or stroke patients to 9.9%, compared with 12.1%.
The landmark Phase III TRITON-TIMI 38 study shows that patients on prasugrel are 35% less likely to have a recurrent event than those who took clopidogrel.
But prasugrel use also carries an increased risk of serious bleeding. For every 1,000 people treated, there were six more TIMI major bleeding events.
The risk of cardiovascular death overall in the study was not statistically different between treatment groups – prasugrel registered 2%, compared with clopidogrel’s 2.2%.
Additional data from further analysis of recurrent events showed that the reduction in recurrent events among prasugrel patients persisted over the 15-month duration of the trial.
Among patients taking prasugrel, there were 58 recurrent events, compared with 115 recurrent events in the clopidogrel group.
The risk of cardiovascular death after a heart attack while on therapy was significantly reduced with prasugrel (3.7%) compared with clopidogrel (7.1%).
Even after adjusting for variables such as age, gender, tobacco use and other health conditions, those taking prasugrel still showed a statistically significant reduction of 34% in recurrent events.
Copyright PA Business 2008
New England Journal of Medicine
