Document Detail


Personalized approaches to clopidogrel therapy: are we there yet?
MedLine Citation:
PMID:  21030701     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Clopidogrel is one of the most commonly prescribed medications worldwide. Recent advisories from the US Food and Drug Administration have drawn attention to the possibility of personalized decision-making for people who are candidates for clopidogrel. As is the case with antihypertensives, statins, and warfarin, common genetic sequence variants can influence clopidogrel metabolism and its effect on platelet activity. These genetic variants have, in multiple studies, been associated with adverse clinical outcomes. Concurrent medication use also influences how the body handles clopidogrel. Proton pump inhibitors, widely prescribed in conjunction with clopidogrel, may blunt its effectiveness. We address implications for bedside decision-making in light of accumulated data and current Food and Drug Administration advisories and conclude that genetic testing for CYP2C19 genotype and limitation of proton pump inhibitor interactions do not yet appear to offer an opportunity to optimize treatment given the current state of knowledge.
Authors:
Christopher D Anderson; Alessandro Biffi; Steven M Greenberg; Jonathan Rosand
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review     Date:  2010-10-28
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  41     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-30     Completed Date:  2010-12-22     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2997-3002     Citation Subset:  IM    
Affiliation:
Division of Neurocritical Care and Emergency Neurology, Stroke Service, Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aryl Hydrocarbon Hydroxylases / genetics
Blood Coagulation / drug effects,  genetics
Clinical Trials as Topic
Humans
Individualized Medicine / methods*
Platelet Aggregation Inhibitors / pharmacokinetics,  therapeutic use*
Ticlopidine / analogs & derivatives*,  pharmacokinetics,  therapeutic use
Grant Support
ID/Acronym/Agency:
R01 NS059727/NS/NINDS NIH HHS; R01 NS059727-02/NS/NINDS NIH HHS; R01 NS059727-03/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
0/Platelet Aggregation Inhibitors; 55142-85-3/Ticlopidine; A74586SNO7/clopidogrel; EC 1.14.14.1/Aryl Hydrocarbon Hydroxylases; EC 1.14.14.1/CYP2C19 protein, human
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Residual vessel length on magnetic resonance angiography identifies poor responders to alteplase in ...
Next Document:  Cerebral microbleeds in the elderly: a pathological analysis.