Dual antiplatelet therapy : net health benefit or harm?

UBC Faculty Research and Publications

Dual antiplatelet therapy : net health benefit or harm? Therapeutics Initiative (University of British Columbia)

Description

Prasugrel and ticagrelor have been suggested as alternatives to clopidogrel for patients presenting with acute coronary syndrome. Therapeutics Letter 94 analyses published RCTs comparing these two new platelet inhibitors with clopidogrel, and includes additional information available from the US FDA’s medical reviews of these RCTs. Long-term dual antiplatelet therapy (vs ASA alone) does not decrease all-cause mortality and increases it in some settings. All antiplatelet agents cause increased bleeding, which reduces their net benefits. Dual antiplatelet therapy is indicated after acute coronary syndrome. It should be started immediately and continued for a maximum duration of 1 year. Most of the benefit occurs in the first 30 days. It is uncertain whether prasugrel or ticagrelor have any therapeutic advantages or disadvantages, compared with clopidogrel.

Item Metadata

Title	Dual antiplatelet therapy : net health benefit or harm?
Alternate Title	Therapeutics Letter 94
Creator	Therapeutics Initiative (University of British Columbia)
Date Issued	2015-06
Description	Prasugrel and ticagrelor have been suggested as alternatives to clopidogrel for patients presenting with acute coronary syndrome. Therapeutics Letter 94 analyses published RCTs comparing these two new platelet inhibitors with clopidogrel, and includes additional information available from the US FDA’s medical reviews of these RCTs. Long-term dual antiplatelet therapy (vs ASA alone) does not decrease all-cause mortality and increases it in some settings. All antiplatelet agents cause increased bleeding, which reduces their net benefits. Dual antiplatelet therapy is indicated after acute coronary syndrome. It should be started immediately and continued for a maximum duration of 1 year. Most of the benefit occurs in the first 30 days. It is uncertain whether prasugrel or ticagrelor have any therapeutic advantages or disadvantages, compared with clopidogrel.
Subject	Acute Coronary Syndrome; Clopidogrel; Platelet Aggregation Inhibitors; Prasugel Hydrochloride; Ticagrelor
Genre	Other
Type	Text
Language	eng
Notes	The UBC TI is funded by the BC Ministry of Health to provide evidence-based information about drug therapy. We neither formulate nor adjudicate provincial drug policies.
Date Available	2023-06-20
Provider	Vancouver : University of British Columbia Library
Rights	Attribution-NonCommercial-NoDerivatives 4.0 International
DOI	10.14288/1.0433673
URI	http://hdl.handle.net/2429/85083
Affiliation	Medicine, Faculty of; Anesthesiology, Pharmacology and Therapeutics, Department of
Peer Review Status	Reviewed
Scholarly Level	Faculty; Researcher
Rights URI	http://creativecommons.org/licenses/by-nc-nd/4.0/
Aggregated Source Repository	DSpace

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