Prakt. lékáren. 2014; 10(5): 161-165

New antiplatelet drugs - prasurgel, ticagrelor, canrelor

Hynek Poul
Oddělení hematologie a transfuziologie, Nemocnice Pelhřimov

Prasugrel, ticagrelor and cangrelor are new antiplatelet drugs acting as platelets ADP receptor P2Y12 blockers. The reasons for the higher

efficacy of new drugs compared to clopidogrel are unproblematic bioactivation (prasugrel) or a direct effect of the substance (ticagrelor,

cangrelor). Acute coronary syndrome and prevention of his subsequent atherothrombotic complications in patiens undergoing

percutaneous coronary intervention are an indication for treatment with these new drugs. They are administered in combination with

acetylsalicylic acid to incerase the therapeutic effect. Prasugrel and ticagrelor are already approved and used in routine clinical practice.

Cangrelor has not been recommended for clinical use and its fate is uncertain. The bleeding complications are the most serious adverse

events of therapy with these drugs. The incidence is higher than for clopidogrel, but it fully correlates to their higher efficiency.

Keywords: prasugrel, ticagrelor, cangrelor, ADP receptor P2Y12 inhibitors

Published: October 24, 2014  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Poul H. New antiplatelet drugs - prasurgel, ticagrelor, canrelor. Praktické lékárenství. 2014;10(5):161-165.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Sofi F, Marcucci R, Gori AM, et al. Residual platelet reactivity on aspirin therapy and recurrent cardiovascular events - A meta-analysis. Int J Cardiol. 2008; 128(2): 166-171. Go to original source... Go to PubMed...
    2. Lau WC, Gurbel PA, Watkins PB, et al. Contribution of hepatic cytochrome P450 3A4 metabolic activity to the phenomenon of clopidogrel resistance. Circulation. 2004; 109(2): 166-171. Go to original source... Go to PubMed...
    3. Gladding P, Webster M, Zeng I, et al. The pharmacogenetics and pharmacodynamics of clopidogrel response: an analysis from the PRINC (Plavix Response in Coronary Intervention) trial. JACC Cardiovasc Interv. 2008; 1(6): 620-627. Go to original source... Go to PubMed...
    4. Li YG, Ni L, Brandt JT, Small DS, et al. Inhibition of platelet aggregation with Prasugrel and clopidogrel: an integrated analysis in 846 subjects. Platelets. 2009; 20(5): 316-327. Go to original source... Go to PubMed...
    5. Bernlochner I, Morath T, Brown PB, et al. A prospective randomized trial comparing the recovery of platelet function after loading dose administration of prasugrel or clopidogrel. Platelets 2012; doi: 10.3109/09537104.2011.654003. Go to original source... Go to PubMed...
    6. Hagihara K, Kazui M, Ikenaga H, et al. Comparison of formation of thiolactones and active metabolites of prasugrel and clopidogrel in rats and dogs. Xenobiotica. 2009; 39(3): 218-226. Go to original source... Go to PubMed...
    7. Dobesh PP. Pharmacokinetics and pharmacodynamics of prasugrel, a thienopyridine P2Y12 inhibitor. Pharmacotherapy. 2009; 29(9): 1089-1102. Go to original source... Go to PubMed...
    8. Mega JL, Close SL, Wiviott SD, et al. Cytochrome P450 genetic polymorphisms and the response to prasugrel: relationship to pharmacokinetic, pharmacodynamic, and clinical outcomes. Circulation. 2009; 119(19): 2553-2560. Epub 2009 May 4. Go to original source... Go to PubMed...
    9. SPC Efient 10 mg potahované tablety.
    10. Antman EM, Wiviott SD, Murphy SA, Voitk J, Hasin Y, Widimsky P, Chandna H, Macias W, McCabe CH, Braunwald E. Early and late benefits of prasugrel in patients with acute coronary syndromes undergoing percutaneous coronary intervention: a TRITON-TIMI 38 (TRial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet InhibitioN with Prasugrel-Thrombolysis In Myocardial Infarction) analysis. J Am Coll Cardiol. 2008; 51(21): 2028-2033. Go to original source... Go to PubMed...
    11. Murphy SA, Antman EM, Wiviott SD, et al. Reduction in recurrent cardiovascular events with prasugrel compared with clopidogrel in patients with acute coronary syndromes from the TRITON-TIMI 38 trial. Eur Heart J 2008; 29: 2473-2479. Go to original source... Go to PubMed...
    12. Wiviott SD, Braunwald E, Angiolillo DJ, Meisel S, Dalby AJ, Verheugt FW, Goodman SG, Corbalan R, Purdy DA, Murphy SA, McCabe CH, Antman EM; TRITON-TIMI 38 Investigators. Greater clinical benefit of more intensive oral antiplatelet therapy with prasugrel in patients with diabetes mellitus in the trial to assess improvement in therapeutic outcomes by optimizing platelet inhibition with prasugrel-Thrombolysis in Myocardial Infarction 38. Circulation. 2008; 118(16): 1626-1636. doi: 10.1161/CIRCULATIONAHA.108.791061. Epub 2008 Aug 31. Go to original source... Go to PubMed...
    13. Montalescot G, Wiviott SD, Braunwald E, Murphy SA, Gibson CM, McCabe CH, Antman EM; TRITON-TIMI 38 investigators.Prasugrel compared with clopidogrel in patients undergoing percutaneous coronary intervention for ST-elevation myocardial infarction (TRITON-TIMI 38): double-blind, randomised controlled trial. Lancet. 2009; 373(9665): 723-731. doi: 10.1016/S0140-6736(09)60441-4. Go to original source... Go to PubMed...
    14. Parodi G, Bellandi B, Venditti F, et al. Residual platelet reactivity, bleedings, and adherence to treatment in patients having coronary stent implantation treated with prasugrel. Am J Cardiol 2012; 109: 214-218. Go to original source... Go to PubMed...
    15. SPC Brilique 90 mg potahované tablety.
    16. Cannon CD, et al. Safety, tolerability, and initial efficacy of AZD6140, the first reversible oral adenosine diphosphate receptor antagonist, compared with clopidogrel, in patiens with non-ST-segment elevation acute coronary syndrome: primary results of the DISPERSE-2 trial. J Am Coll Cardiol. 2007; 6, 50 (19): 1844-1851. Go to original source... Go to PubMed...
    17. Wallentin L, Becker RC, Budaj A, Cannon CP, Emanuelsson H, Held C, Horrow J, Husted S, James S, Katus H, Mahaffey KW, Scirica BM, Skene A, Steg PG, Storey RF, Harrington RA, PLATO Investigators, Freij A, Thorsén M. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med. 2009; 361(11): 1045-1057. Go to original source... Go to PubMed...
    18. Held C1, Asenblad N, Bassand JP, Becker RC, Cannon CP, Claeys MJ, Harrington RA, Horrow J, Husted S, James SK, Mahaffey KW, Nicolau JC, Scirica BM, Storey RF, Vintila M, Ycas J, Wallentin L. Ticagrelor versus clopidogrel in patients with acute coronary syndromes undergoing coronary artery bypass surgery: results from the PLATO (Platelet Inhibition and Patient Outcomes) trial. J Am Coll Cardiol. 2011 Feb 8;57(6): 672-684. doi: 10.1016/j.jacc.2010.10.02 9. Epub 2010 Dec 30.
    19. Cattaneo M, Schulz R, Nylander S. Adenosine-Mediated Effects of Ticagrelor: Evidence and Potential Clinical Relevance. J Am Coll Cardiol. 2014; 63(23): 2503-2509. doi: 10.1016/j.jacc.2014.03.031. Epub 2014 Apr 23. Go to original source... Go to PubMed...
    20. Cattaneo M, Faioni EM. Why does ticagrelor induce dyspnea? Thromb Haemost. 2012; 108(6): 1031-1036. doi: 10.1160/TH12-08-0547. Epub 2012 Oct 16. Go to original source... Go to PubMed...
    21. White HD, Chew DP, Dauerman HL, Mahaffey KW, Gibson CM, Stone GW, Gruberg L, Harrington RA, Bhatt DL. Reduced immediate ischemic events with cangrelor in PCI: a pooled analysis of the CHAMPION trials using the universal definition of myocardial infarction. Am Heart J. 2012; 163(2): 182-190.e4. Go to original source... Go to PubMed...
    22. Bhatt DL, Stone GW, Mahaffey KW, Gibson CM, Steg PG, Hamm CW, Price MJ, Leonardi S, Gallup D, Bramucci E, Radke PW, Widimský P, Tousek F, Tauth J, Spriggs D, McLaurin BT, Angiolillo DJ, Généreux P, Liu T, Prats J, Todd M, Skerjanec S, White HD, Harrington RA; CHAMPION PHOENIX Investigators. Effect of platelet inhibition with cangrelor during PCI on ischemic events. N Engl J Med. 2013; 368(14): 1303-1313. doi: 10.1056/NEJMoa1300815. Epub 2013 Mar 10. Go to original source... Go to PubMed...
    23. Angiolillo DJ, Firstenberg MS, Price MJ, Tummala PE, Hutyra M, Welsby IJ, Voeltz MD, Chandna H, Ramaiah C, Brtko M, Cannon L, Dyke C, Liu T, Montalescot G, Manoukian SV, Prats J, Topol EJ; BRIDGE Investigators. Bridging antiplatelet therapy with cangrelor in patients undergoing cardiac surgery: a randomized controlled trial. JAMA. 2012; 307(3): 265-274. doi: 10.1001/jama.2011.2002. Go to original source... Go to PubMed...

    Return to the content


    Pharmacy for Practice

    Madam, Sir,
    please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
    Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

    I declare:

    1. that I have met the above instruction
    2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited

    No
    Yes

    If your statement is not true, please be aware
    that brings the risk of danger to their health or the health of others.