Clopidogrel dosing and role of genetics: ELEVATE-TIMI 56 trial: Difference between revisions
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(/* ELEVATE-TIMI 56 trial {{cite journal| author=Mega JL, Hochholzer W, Frelinger AL, Kluk MJ, Angiolillo DJ, Kereiakes DJ et al.| title=Dosing clopidogrel based on CYP2C19 genotype and the effect on platelet reactivity in patients with stable cardiov) |
(/* ELEVATE-TIMI 56 trial {{cite journal| author=Mega JL, Hochholzer W, Frelinger AL, Kluk MJ, Angiolillo DJ, Kereiakes DJ et al.| title=Dosing clopidogrel based on CYP2C19 genotype and the effect on platelet reactivity in patients with stable cardiov) |
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* '''Primary end point''' - Platelet function test results and adverse events. | * '''Primary end point''' - Platelet function test results and adverse events. | ||
* ''' | * '''Conclusions''' - Increasing the maintenance dose of clopidogrel to 225 mg daily in CYP2C19*2 heterozygotes with cardiovascular diseases was able to cause similar levels of platelet reactivity as seen with the standard 75-mg dose in noncarriers. However, in patients who were homozygotes for CYP2C19*2 genes, doses as high as 300 mg daily did not result in comparable degrees of platelet inhibition. | ||
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==References== | ==References== | ||
Revision as of 15:21, 25 November 2011
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]
Overview
The results of the ELEVATE-TIMI 56 trial were recently presented in AHA 2011 held at Orlando, Florida.
ELEVATE-TIMI 56 trial [1]
- Hypothesis - To assess whether increasing the dose of clopidogrel to 300 mg / day rather than the standard 75 mg / day maintenance dose improves outcomes in patients with loss-of-function CYP2C19 genotypes.
- Study design - Multicenter, randomized, double-blind trial
- Duration of study - 1 years
- Intervention - Maintenance doses of clopidogrel for 4 treatment periods, (each treatment period lasted 14 days). 247 noncarriers received 75 and 150 mg daily of clopidogrel (2 periods each), and 86 carriers (80 heterozygotes, 6 homozygotes) received 75, 150, 225, and 300 mg daily.
- Primary end point - Platelet function test results and adverse events.
- Conclusions - Increasing the maintenance dose of clopidogrel to 225 mg daily in CYP2C19*2 heterozygotes with cardiovascular diseases was able to cause similar levels of platelet reactivity as seen with the standard 75-mg dose in noncarriers. However, in patients who were homozygotes for CYP2C19*2 genes, doses as high as 300 mg daily did not result in comparable degrees of platelet inhibition.
References
- ↑ Mega JL, Hochholzer W, Frelinger AL, Kluk MJ, Angiolillo DJ, Kereiakes DJ; et al. (2011). "Dosing clopidogrel based on CYP2C19 genotype and the effect on platelet reactivity in patients with stable cardiovascular disease". JAMA. 306 (20): 2221–8. doi:10.1001/jama.2011.1703. PMID 22088980.