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Prasugrel: Indications of an additional benefit for some patients, but also of greater harm
Date:9/15/2011

In order to better prevent blood clots, the drugs clopidogrel or prasugrel can be prescribed to patients with acute ischaemia of the heart muscle, in addition to acetylsalicylic acid (ASA). The German Institute for Quality and Efficiency in Health Care (IQWiG) has now investigated whether, in patients whose vessels were dilated by a percutaneous coronary intervention (PCI), the combination of prasugrel plus ASA has a higher patient-relevant benefit than ASA alone, or than combination therapy with clopidogrel plus ASA. The findings of the assessment provide indications that prasugrel decreases the risk of further non-fatal heart attacks better than clopidogrel in some patients, but that major bleeding events occur more often. This is the result of a final report presented by IQWiG on 5 September 2011.

ASA and prasugrel should complement each other in their effect

Prasugrel has been available on the German market since 2009 under the trade name "Efient" and in some patients can be used as an alternative to the drug clopidogrel, which was already assessed by IQWiG in 2009.

Like clopidogrel, prasugrel is an anti-platelet drug ("platelet aggregation inhibitor") that is used in a similar way to ASA. It inhibits parts of the blood-clotting system, leading to a reduction in platelet clotting (aggregation) and of the subsequent formation of blood clots (thrombi). Prasugrel is thus supposed to reduce the risk of heart attacks and strokes, for example. However, the risk of bleeding may increase. As the manner in which prasugrel and ASA act on blood clotting differs, it is assumed that the 2 drugs complement each other and that the overall inhibitory effect on the formation of blood clots increases. Prasugrel differs mainly from clopidogrel through its faster onset of action, and is intended to be used if a rapid treatment effect is required.

Different approval status for clopidogrel and prasugrel

Prasugrel is a
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Contact: Dr. Anna-Sabine Ernst
info@iqwig.de
49-022-135-6850
Institute for Quality and Efficiency in Health Care
Source:Eurekalert

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