Prasugrel With Lower Dose - Loading Dose

NCT ID: NCT02070159

Last Updated: 2014-02-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

43 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-12-31

Study Completion Date

2013-01-31

Brief Summary

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Although prasugrel, recently available thienopyridine derivative, exhibits rapid and potent platelet inhibition, concerns of low on-treatment platelet reactivity have been suggested especially in East Asian ethnicities. The investigators compared the effect of lower loading dose of prasugrel with conventional loading dose of clopidogrel and prasugrel.

Detailed Description

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Although clopidogrel together aspirin has been a backbone of anti-platelet therapy in coronary artery disease patients, clopidogrel has several limitations. It has delayed onset of peak concentration and pharmacodynamic inter-patient response variability resulting in high on-treatment platelet reactivity (HPR). Those demerits are known to be associated with adverse cardiovascular outcomes.

Prasugrel has a more effective metabolism pathway than clopidogrel and exhibits more rapid and potent platelet inhibition. Recent guidelines recommend prasugrel as a first line antiplatelet agent or put precedence over clopidogrel for the patients with acute coronary syndrome. However, there have been concerns of different pharmacodynamic and pharmacokinetic response to prasugrel in East Asian ethnicities.

In addition, lower loading dose of prasugrel exhibited more potent pharmacodynamic effect than clopidogrel 600 mg with comparable efficacy compared to conventional loading dose of prasugrel in healthy Korean subjects.

The investigators compare the antiplatelet effect of lower loading dose of prasugrel 30 mg with conventional loading dose of clopidogrel 600 mg and prasugrel 60 mg in Korean coronary artery disease patients undergoing elective coronary angiography.

Conditions

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Coronary Artery Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Clopidogrel 600 mg

Patients administer conventional loading dose of clopidogrel 600 mg as active comparators.

Group Type ACTIVE_COMPARATOR

Clopidogrel 600 mg

Intervention Type DRUG

Patients administer 600 mg of clopidogrel as conventional loading dose of clopidogrel

Prasugrel 30 mg

Patients administer lower loading dose of prasugrel 30 mg.

Group Type EXPERIMENTAL

Prasugrel 30 mg

Intervention Type DRUG

Patients administer 30 mg of prasugrel as lower loading dose of prasugrel.

Prasugrel 60 mg

Patients administer conventional loading dose of prasugrel 60 mg as active comparators.

Group Type ACTIVE_COMPARATOR

Prasugrel 60 mg

Intervention Type DRUG

Patients take 60 mg of prasugrel as conventional loading dose of prasugrel.

Interventions

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Clopidogrel 600 mg

Patients administer 600 mg of clopidogrel as conventional loading dose of clopidogrel

Intervention Type DRUG

Prasugrel 30 mg

Patients administer 30 mg of prasugrel as lower loading dose of prasugrel.

Intervention Type DRUG

Prasugrel 60 mg

Patients take 60 mg of prasugrel as conventional loading dose of prasugrel.

Intervention Type DRUG

Other Intervention Names

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Plavix 600 mg Effient 30 mg Effient 60 mg

Eligibility Criteria

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Inclusion Criteria

* Patients between 18 and 80 years
* Stable or unstable angina
* Planned to undergo elective coronary angiography

Exclusion Criteria

* Previous history of transient ischemic attack or stroke
* Intracranial neoplasm
* Uncontrolled malignant disease
* History of antiplatelet or anticoagulation treatment within 1 month
* Contraindication to the study drug
* Bleeding diathesis
* Hemoglobin \< 10 g/dl
* Platelet count \< 100,000/mm3
* Significant renal insufficiency (glomerular filtration rate \<60 mL/min/1.73 m2)
* Significant hepatic impairment (Serum liver enzyme or bilirubin \> 3 times normal limit)
* Body weight \< 50 kg
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Dong-A University

OTHER

Sponsor Role lead

Responsible Party

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Moo Hyun Kim

MD. Director, Regional Clinical Trial Center. Professor, Dept. of Cardiology Dong-A University Hospital

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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DongA University Hospital

Busan, , South Korea

Site Status

Countries

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South Korea

References

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Kim MH, Zhang HZ, Jung DK. Pharmacodynamic comparisons for single loading doses of prasugrel (30 mg) and clopidogrel (600 mg) in healthy Korean volunteers. Circ J. 2013;77(5):1253-9. doi: 10.1253/circj.cj-12-0783. Epub 2013 Jan 30.

Reference Type BACKGROUND
PMID: 23363643 (View on PubMed)

Other Identifiers

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PRELOAD-LD

Identifier Type: -

Identifier Source: org_study_id

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