Blood thinner Effient is a rising star — but is it safe?
Monday, July 13th, 2009
Last week, the Japanese drugmaker Daiichi Sankyo Co. received FDA approval to market its anti-blood-clotting drug Effient (prasugrel) in the United States. The thumbs up from the U.S. government has made the drugmaker a rising star in the Japanese stock market.
But the jury is still out on whether Effient will be able to compete with market leader Plavix — particularly given concerns that the Japanese drug causes a high rate of internal bleeding in patients.
Like Plavix (clopidogrel), Effient is a platelet inhibitor. Platelet inhibitors encourage blood flow to the heart, brain, and body. They are prescribed to reduce the risk of heart attack, stroke, and circulation problems in patients with hardening of the arteries or unstable angina, and in those who’ve already suffered a heart attack or stroke.
Studies suggest Effient may be more effective than Plavix in preventing heart attacks and other cardiovascular deaths — but that Effient deaths by internal bleeding basically cancel these advantages out.
A study of more than 13,000 patients with acute coronary syndromes, published in the New England Journal of Medicine, compared prasugrel against clopidogrel, both in combination with aspirin, and found that prasugrel was the more potent anti-platelet agent.
Prasugrel reduced the combined rate of death from cardiovascular causes. The death rate was 9.9 percent for prasugrel, compared to 12.1 percent for clopidogrel.
However, an increased rate of internal bleeding — including fatal bleeding — occurred in the group taking prasugrel. As a result, overall mortality between the two groups was almost identical. The drug has been deemed especially risky for elderly patients.
So pick your poison — a higher risk of death by myocardial infarction with Plavix, or by internal bleeding with Effient. As always, consult with your physician in determining how to treat any condition.
