En els últims dies s'han difós noves dades de l'estudi MEDCO sobre la interacció entre clopidogrel i inhibidors de la bomba de protons (IBP).
Segons aquestes dades, l'augment del risc d'efectes cardiovasculars adversos relacionat amb l'ús d'aquests fàrmacs és estadísticament significatiu per a omeprazol, lansoprazol, esomeprazol i pantoprazol:Efectes cardiovasculars adversos majors per IBP.
Aquests resultats suggereixen un efecte de classe i recolzen les recomanacions abocades recentment en REMI [2] en el sentit que pantoprazol o esomeprazol no són una bona alternativa a omeprazol en pacients que prenen clopidogrel, i que són preferibles els inhibidors H2.
Per Jaime Latour Pérez
Hospital Universitario de Elche ©REMI, http://remi.uninet.edu/. Mayo 2009.
Enllaços:
Wood S. Possible "Class Effect" for Proton-Pump Inhibitors on Top of Clopidogrel Therapy. [Medscape]
Latour-Pérez J. ¿Debemos abandonar el uso conjunto de clopidogrel e inhibidores de la bomba de protones? [REMI 2009; 9 (3): A98]
Mehta SR, Boden WE, Eikelboom JW, Flather M, Steg PG, Avezum A, Afzal R, Piegas LS, Faxon DP, Widimsky P, Budaj A, Chrolavicius S, Rupprecht HJ, Jolly S, Granger CB, Fox KA, Bassand JP, Yusuf S; OASIS 5 and 6 Investigators. Antithrombotic therapy with fondaparinux in relation to interventional management strategy in patients with ST- and non-ST-segment elevation acute coronary syndromes: an individual patient-level combined analysis of the Fifth and Sixth Organization to Assess Strategies in Ischemic Syndromes (OASIS 5 and 6) randomized trials. Circulation 2008; 118: 2038-2046. [PubMed]
Wood S. Possible "Class Effect" for Proton-Pump Inhibitors on Top of Clopidogrel Therapy. [Medscape]
Latour-Pérez J. ¿Debemos abandonar el uso conjunto de clopidogrel e inhibidores de la bomba de protones? [REMI 2009; 9 (3): A98]
Mehta SR, Boden WE, Eikelboom JW, Flather M, Steg PG, Avezum A, Afzal R, Piegas LS, Faxon DP, Widimsky P, Budaj A, Chrolavicius S, Rupprecht HJ, Jolly S, Granger CB, Fox KA, Bassand JP, Yusuf S; OASIS 5 and 6 Investigators. Antithrombotic therapy with fondaparinux in relation to interventional management strategy in patients with ST- and non-ST-segment elevation acute coronary syndromes: an individual patient-level combined analysis of the Fifth and Sixth Organization to Assess Strategies in Ischemic Syndromes (OASIS 5 and 6) randomized trials. Circulation 2008; 118: 2038-2046. [PubMed]
Cercla a PubMed:
Enunciat: "Clopidogrel e inhibidores de la bomba de protones"
Sintaxis: clopidogrel AND proton pump inhibitors
[Resultados]
Enunciat: "Clopidogrel e inhibidores de la bomba de protones"
Sintaxis: clopidogrel AND proton pump inhibitors
[Resultados]
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