Abstract
Background: The aim of the present interim analysis was to compare the clinical efficacy and safety of the generic clopidogrel besylate (CB) with the innovator clopidogrel hydrogen sulphate (CHS) salt in patient groups eligible to receive clopidogrel.
Methods: A 2-arm, multicenter, open-label, phase 4 clinical trial. Consecutive patients (n=1,864) were screened and 1,800 were enrolled in the trial and randomized to CHS (n=759) or CB (n=798). Primary efficacy end point was the composite of myocardial infarction, stroke or death from vascular causes, and primary safety end point was rate of bleeding events as defined by Bleeding Academic Research Consortium (BARC) criteria.
Results: At 6-months follow-up no differences were observed between CB and CHS in primary efficacy end point (OR, 0.80; 95% CI, 0.37 to 1.71; p=0.57). Rates of BARC-1,-2,-3a and -5b bleeding were similar between the two study groups whereas no bleeding events according to BARC-3b, -3c, -4 and -5a were observed in either CHS or CB group.
Conclusion: The clinical efficacy and safety of the generic CB is similar to that of the innovator CHS salt, thus, it can be routinely used in the secondary prevention of atherothrombotic events for a period of at least 6 months. (Salts of Clopidogrel: Investigation to ENsure Clinical Equivalence, SCIENCE study Clinical Trials.gov Identifier: NCT02126982).
Keywords: Acute coronary syndrome, clinical efficacy, clopidogrel besylate, coronary artery disease, generic clopidogrel, peripheral artery disease, stroke.
Current Vascular Pharmacology
Title:Generic Clopidogrel Besylate in the Secondary Prevention of Atherothrombotic Events: A 6-month Follow-up of a Randomised Clinical Trial
Volume: 13 Issue: 6
Author(s): Kyriafina Terzoudi, Spiros Konstantinou, Haralampos Milionis, Adamantios Bourdakis, Dimitrios Nikolopoulos, Leonidas Peltekis, Nikos Prokopakis, Ioannis Sinteles, Christos S. Stroumbis, Nikolaos Kipouridis, Karmelos Tsilias, Ioannis Xaraktsis, Christos Charmpas, Georgios Hatziathanasiou, Zacharias Christogiannis, Demosthenes B. Panagiotakos, John A. Goudevenos, Alexandros D. Tselepis, Ioannis Giatrakos, Kalliroi I. Kalantzi, Maria E. Tsoumani, John N. Vakalis, Vasileios Vasilakopoulos, Konstantinos Vardakis, Konstantinos N. Vemmos, Maria Voukelatou, Georgios Giannakoulas, Ioannis V. Ntalas, Vasileios Giogiakas, Georgios Goumas, Nikos Dimoulis, Antonios Draganigos, Ioannis Efthimiadis, Maria Thoma and Evangelos Kazakos
Affiliation:
Keywords: Acute coronary syndrome, clinical efficacy, clopidogrel besylate, coronary artery disease, generic clopidogrel, peripheral artery disease, stroke.
Abstract: Background: The aim of the present interim analysis was to compare the clinical efficacy and safety of the generic clopidogrel besylate (CB) with the innovator clopidogrel hydrogen sulphate (CHS) salt in patient groups eligible to receive clopidogrel.
Methods: A 2-arm, multicenter, open-label, phase 4 clinical trial. Consecutive patients (n=1,864) were screened and 1,800 were enrolled in the trial and randomized to CHS (n=759) or CB (n=798). Primary efficacy end point was the composite of myocardial infarction, stroke or death from vascular causes, and primary safety end point was rate of bleeding events as defined by Bleeding Academic Research Consortium (BARC) criteria.
Results: At 6-months follow-up no differences were observed between CB and CHS in primary efficacy end point (OR, 0.80; 95% CI, 0.37 to 1.71; p=0.57). Rates of BARC-1,-2,-3a and -5b bleeding were similar between the two study groups whereas no bleeding events according to BARC-3b, -3c, -4 and -5a were observed in either CHS or CB group.
Conclusion: The clinical efficacy and safety of the generic CB is similar to that of the innovator CHS salt, thus, it can be routinely used in the secondary prevention of atherothrombotic events for a period of at least 6 months. (Salts of Clopidogrel: Investigation to ENsure Clinical Equivalence, SCIENCE study Clinical Trials.gov Identifier: NCT02126982).
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Terzoudi Kyriafina, Konstantinou Spiros, Milionis Haralampos, Bourdakis Adamantios, Nikolopoulos Dimitrios, Peltekis Leonidas, Prokopakis Nikos, Sinteles Ioannis, Stroumbis S. Christos, Kipouridis Nikolaos, Tsilias Karmelos, Xaraktsis Ioannis, Charmpas Christos, Hatziathanasiou Georgios, Christogiannis Zacharias, Panagiotakos B. Demosthenes, Goudevenos A. John, Tselepis D. Alexandros, Giatrakos Ioannis, Kalantzi I. Kalliroi, Tsoumani E. Maria, Vakalis N. John, Vasilakopoulos Vasileios, Vardakis Konstantinos, Vemmos N. Konstantinos, Voukelatou Maria, Giannakoulas Georgios, Ntalas V. Ioannis, Giogiakas Vasileios, Goumas Georgios, Dimoulis Nikos, Draganigos Antonios, Efthimiadis Ioannis, Thoma Maria and Kazakos Evangelos, Generic Clopidogrel Besylate in the Secondary Prevention of Atherothrombotic Events: A 6-month Follow-up of a Randomised Clinical Trial, Current Vascular Pharmacology 2015; 13 (6) . https://dx.doi.org/10.2174/1570161113666150316220515
DOI https://dx.doi.org/10.2174/1570161113666150316220515 |
Print ISSN 1570-1611 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6212 |
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Cardiovascular disease still remains the leading cause of death in Chronic and End Stage Kidney Disease, accounting for more than half of all deaths in dialysis patients. During the past decade, research has been focused on novel therapeutic agents that might delay or even reverse cardiovascular disease and vascular calcification, ...read more
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