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New Research Confirms the Benefit of Extended-Release Dipyridamole,Plus ASA for Preventing Recurrent Stroke in Low- and High-Risk,Patients

re the recent European Australasian Stroke Prevention in Reversible Ischaemia Trial (ESPRIT),2 and the second European Stroke Prevention Study (ESPS 2).3 Both of these trials reported significant reductions in the incidence of recurrent stroke in patients treated with dipyridamole plus ASA compared with ASA alone (a total of 83 percent of the patients received extended-release dipyridamole, and up to 8 percent received the fixed-dose combination twice daily, which is marketed as Aggrenox® or Asasantin®).

A smaller proportion of patients included in the meta-analysis received an immediate release formulation of dipyridamole that may provide suboptimal plasma levels in some patients. The better absorption properties of Aggrenox® were also discussed by Professor Hartmut Derendorf of the University of Florida, U.S.A. in a symposium at the European Stroke Conference, who demonstrated that the extended-release dipyridamole formulation found in Aggrenox® is better absorbed than an immediate release dipyridamole formulation.4 This optimized formulation is buffered, allowing absorption despite fluctuations in the gastric acidity. This is particularly beneficial for elderly stroke patients in whom reduced gastric acidity or gastric and duodenal ulcer therapy is widespread.5

Stroke is the third leading cause of death worldwide after heart disease and cancer.6 Patients who survive a first stroke or TIA are at high risk of suffering a second stroke and require preventive treatment to reduce this risk. 7 The world’s largest secondary stroke prevention study - PRoFESS® (Prevention Regimen For Effectively avoiding Second Strokes) – aims to demonstrate that Aggrenox® is superior in preventing secondary strokes compared with clopidogrel. The trial has enrolled 20,333 patients in 35 countries.8

The results of PRoFESS® are expected at the European Stroke Conference in Nice, France in 2008.

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