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Updated: Jun 25, 2026
Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Novel antiplatelet agents in development: prasugrel, ticagrelor, and cangrelor and beyond
Inna Shalito1, Olga Kopyleva, Victor Serebruany
1HeartDrug Research Laboratories, Johns Hopkins University, Towson, MD 21204, USA.
Insights
Novel antiplatelet agents are crucial due to limitations of current therapies like aspirin and clopidogrel. This review explores new drugs, including adenosine diphosphate receptor blockers and glycoprotein VI antagonists, for treating atherothrombotic diseases.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Biochemistry
Background:
- Atherosclerosis leads to atherothrombotic diseases like coronary artery disease and stroke, causing significant mortality and economic burden.
- Current antiplatelet therapies, including aspirin and clopidogrel, have shown efficacy but exhibit limitations such as variable response and resistance.
- The need for novel oral antiplatelet agents is critical to improve patient outcomes and address therapeutic shortcomings.
Purpose of the Study:
- To review the developmental progress of novel oral antiplatelet agents.
- To highlight experimental agents targeting platelet activation pathways.
Main Methods:
- Review of current literature on antiplatelet drug development.
- Focus on adenosine diphosphate (ADP) receptor blockers (prasugrel, ticagrelor, cangrelor).
- Examination of platelet glycoprotein VI (GPVI) adhesion antagonists, specifically PR-15.
Main Results:
- Established antiplatelet drugs have limitations in efficacy and patient response.
- Novel agents like ADP receptor blockers and GPVI antagonists are under development.
- These new agents aim to overcome the shortcomings of existing therapies.
Conclusions:
- Development of novel oral antiplatelet agents is essential for managing atherothrombotic diseases.
- Experimental drugs targeting ADP receptors and GPVI offer promising alternatives.
- Further research and clinical trials are necessary to establish the efficacy and safety of these novel agents.
Abstract:
Coronary artery disease, stroke, and peripheral vascular disease are known as "atherothrombotic" manifestations of atherosclerosis. These devastating conditions remain the major contributor of mortality and disability in a modern Western world, with estimated direct and indirect cost for 403.1 billion dollars in the United States alone. The application of current evidence-based therapy including the administration of low-dose aspirin and standard of care with clopidogrel proved to exhibit absolute mortality reduction in the randomized clinical trials International Study for Infarct Survival and Clopidogrel and Metoprolol in Myocardial Infarction Trial among patients after acute vascular events. However, these established antiplatelet medications have certain shortcomings including lack of efficacy in some patients, significant response variability, and potential "resistance." Therefore, intelligent development of novel oral antiplatelet agents is difficult to underestimate. In this review, we will focus on the developmental efforts with regard to the experimental agents such as adenosine diphosphate receptor blockers (prasugrel, ticagrelor, and cangrelor) and platelet glycoprotein VI adhesion antagonist [ProCorde GmbH 15 (PR-15)].
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