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ADP-receptor blockade: A case for personalised pharmacotherapy?
Christine S Zürn1, Tobias Geisler, Meinrad Gawaz
1Medizinische Klinik III, Kardiologie und Kreislauferkrankungen, Eberhard Karls Universität Tübingen, Germany. christine.zuern@med.uni-tuebingen.de
Thrombosis and Haemostasis
|January 16, 2010
Summary
Clopidogrel, a standard antiplatelet drug, shows variable patient response, increasing cardiovascular event risk. Personalized therapy and new drugs aim for better efficacy and reduced variability.
Area of Science:
- Pharmacology
- Cardiology
- Clinical Medicine
Background:
- Dual antiplatelet therapy with aspirin and clopidogrel is standard post-acute coronary events.
- Clopidogrel exhibits significant interindividual response variability, impacting efficacy.
- Variability in clopidogrel response is linked to higher rates of recurrent cardiovascular events.
Purpose of the Study:
- To review clopidogrel treatment failure based on platelet function testing.
- To discuss mechanisms of existing and novel ADP-receptor blockers.
- To explore new therapeutic principles for antiplatelet pharmacotherapy.
Main Methods:
- Review of clinical trials and scientific literature.
- Analysis of factors contributing to clopidogrel response variability.
- Discussion of platelet function testing for efficacy verification.
Main Results:
- Clopidogrel's variable response is influenced by clinical and non-genetic factors.
- Standardized platelet function testing can identify treatment failure.
- New ADP-blockers promise more consistent efficacy with less variability.
Conclusions:
- Individualized antithrombotic pharmacotherapy is the goal for clopidogrel-treated patients.
- Risk stratification is needed to identify patients benefiting from personalized therapy.
- Further research is required to define bleeding risk and side effects of new agents.
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