|
KMID : 0338420100250020154
|
|
The Korean Journal of Internal Medicine
2010 Volume.25 No. 2 p.154 ~ p.161
|
|
|
The Impact of Generic Clopidogrel Bisulfate on Platelet Inhibition in Patients with Coronary Artery Stents: Results of the ACCEL-GENERIC Study
|
|
Jeong Young-Hoon
Koh Jin-Sin
Kang Min-Kyung
Ahn Yeon-Jeong
Kim In-Suk
Park Yong-Whi
Hwang Seok-Jae
Kwak Choong-Hwan
Hwang Jin-Yong
|
|
|
Abstract
|
|
|
Background/Aims: In patients with coronary artery stents, the cost of clopidogrel has been cited as a factor in the premature discontinuation of therapy. Thus, the introduction of lower-cost generic clopidogrel may increase patient compliance. However, platelet inhibition by generic clopidogrel has not been compared to the original clopidogrel formulation in patients with coronary artery stents.
Methods: We prospectively enrolled 20 patients receiving chronic therapy with the original clopidogrel bisulfate (Plavix®). After assessing patient compliance with Plavix®, maintenance therapy was switched to generic clopidogrel bisulfate (Plavitor®). Platelet reactivity was assessed at baseline and 30-day after the switch using conventional aggregometry and the VerifyNow P2Y12 assay.
Results: All patients completed maintenance therapy with Plavitor®. Before and after switching therapy maximal (36.5 ± 7.9% vs. 39.8 ± 16.2%, p = 0.280) and late platelet aggregation (23.5 ± 10.9% vs. 29.1 ± 18.3%, p = 0.156) with 5 μmol/L adenosine diphosphate (ADP) stimulus did not differ. Likewise, 20 μmol/L ADP-induced platelet aggregation and P2Y12 reaction unit in patients on Plavitor® therapy was comparable to that in patients on Plavix® therapy. However, Bland-Altman analysis showed wide limits of agreement between measured platelet reactivity on Plavix® vs. Plavitor® therapies.
Conclusions: Among patients on Plavix® maintenance therapy with coronary stents, replacement with Plavitor® shows a comparable inhibition of ADP-induced platelet aggregation. However, due to poor inter-therapy agreement, between two regimens, physicians may be cautious when introducing generic clopidogrel bisulfate.
|
|
|
KEYWORD
|
|
|
Clopidogrel, Drugs, generic, Blood platelets, Purinoceptor P2Y12
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
    
|
|