Aspirin plus PPI better than Plavix in patients with GI bleed
pharmafile | February 2, 2005 | News story | Sales and Marketing |
A new study has concluded that aspirin plus a proton pump inhibitor (PPI) is more effective than Plavix (clopidogrel) in preventing recurrent gastro-intestinal bleeding.
The New England Journal of Medicine published results of the controlled trial which suggests the combination as a more effective and cheaper alternative to Plavix.
Patients in the trial had previously suffered ulcer bleeding but also required anti-platelet therapy. Current US guidelines recommend Plavix when the original bleed was caused by aspirin, but the study suggests the addition of PPI esomeprazole (AstraZeneca's Nexium) to aspirin provides the necessary gastro-intestinal protection.
The study found that recurrent bleeding occurred in 13 (8%) of the patients on Plavix but just one (0.6%) of those on aspirin plus esomeprazole.
The study, carried out over 12 months, randomised 320 patients to receive either aspirin 80mg plus esomeprazole or Plavix plus placebo.
Reacting to the findings, Exeter GP Dr Adrian Midgley, said: "I'd say that – probably to the delight of my PCT prescribing adviser – I feel less pressure to give clopidogrel to someone who had a bleed or dyspepsia with aspirin."
A spokesman for market analysts Infopharm said the trial results will make it more difficult for Sanofi-Aventis/BMS sales reps to promote the drug for GI bleeding.
Co-marketed by Sanofi-Aventis and BMS, Plavix is one of the fastest growing drugs in the UK and globally and is being used in an increasing number of clinical settings.
Sanofi-Aventis said that data from its CAPRIE trial, showed Plavix demonstrated a significantly superior profile compared to aspirin in regard to GI bleeding.
The company says Plavix's safety and efficacy record has been established through clinical trials involving over 100,000 patients.
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