uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Prasugrel: A novel thienopyridine antiplatelet agent: A review of preclinical and clinical studies and the mechanistic basis for its distinct antiplatelet profile
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
2007 (English)In: Cardiovascular Drug Reviews, ISSN 0897-5957, E-ISSN 1527-3466, Vol. 25, no 4, 357-374 p.Article, review/survey (Refereed) Published
Abstract [en]

Prasugrel (CS-747, LY640315) is a novel member of the thienopyridine class of oral antiplatelet agents that includes ticlopidine and clopidogrel. Like other thienopyridines, prasugrel is a prodrug that is inactive in vitro. Prasugrel's distinct chemical structure permits efficient conversion to its active metabolite with a less rigorous dependence on specific cytochrome P-450 enzymes. Prasugrel is rapidly converted in vivo to an active metabolite (R-138727) that binds specifically and irreversibly to the platelet P2Y(12) purinergic receptor inhibiting ADP-mediated platelet activation and aggregation. Preclinical studies indicated that prasugrel is approximately 10- and 100-fold more potent at inhibiting ex vivo platelet aggregation and in vivo thrombus formation than clopidogrel and ticlopidine, respectively. Early clinical data in healthy subjects confirmed the greater platelet inhibition and consistency with prasugrel compared to clopidogrel. While the active metabolites of prasugrel and clopidogrel resulted in similar levels of platelet inhibition in vitro, the amount of each active metabolite generated in vivo was quite different-prasugrel (60 mg) resulting in an approximately 12-fold greater exposure to its active metabolite compared with clopidogrel (300 mg). This observation provides a mechanistic basis for the faster, greater, and more consistent inhibition of platelet aggregation observed with prasugrel. Clinical studies in patients with cardiovascular disease confirmed the potent antiplatelet effect of prasugrel compared with clopidogrel. Collectively, these phase 1/1b studies and a phase 2 study (JUMBO-TIMI 26) aided in dose selection for the recently completed phase 3 trial (TRITON-TIMI 38) in patients with acute coronary syndrome undergoing percutaneous coronary intervention.

Place, publisher, year, edition, pages
2007. Vol. 25, no 4, 357-374 p.
Keyword [en]
acute coronary syndrome, clopidogrel, platelets, prasugrel, P2Y(12), thienopyridines
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-152102DOI: 10.1111/j.1527-3466.2007.00027.xISI: 000251503600005OAI: oai:DiVA.org:uu-152102DiVA: diva2:412492
Available from: 2011-04-25 Created: 2011-04-25 Last updated: 2012-07-13Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full text

Search in DiVA

By author/editor
Wallentin, Lars
By organisation
Department of Medical SciencesUCR-Uppsala Clinical Research Center
In the same journal
Cardiovascular Drug Reviews
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

Altmetric score

Total: 186 hits
ReferencesLink to record
Permanent link

Direct link