Prasugrel 5 mg in the very elderly attenuates platelet inhibition but maintains noninferiority to prasugrel 10 mg in nonelderly patients: The GENERATIONS trial, a pharmacodynamic and pharmacokinetic study in stable coronary artery disease patients

David Erlinge, Paul A. Gurbel, Stefan James, Tomas L. Lindahl, Peter Svensson, Jurrien M. Ten Berg, David P. Foley, Henrik Wagner, Patricia B. Brown, Junxiang Luo, Chunmei Zhou, Brian A. Moser, Joseph A. Jakubowski, David S. Small, Kenneth J. Winters, Dominick J. Angiolillo

Research output: Contribution to journalArticle

Abstract

Objectives This study assessed pharmacodynamic (PD) response to the reduced prasugrel maintenance dose of 5 mg in very elderly (VE) patients (≥75 years of age). Background In the TRITON-TIMI 38 (TRial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet InhibitioN with Prasugrel- Thrombolysis In Myocardial Infarction 38) study prasugrel 10 mg reduced ischemic events versus clopidogrel 75 mg, but increased bleeding in VE patients. Methods We examined PD and active metabolite pharmacokinetics (PKs) with prasugrel 5 and 10 mg and clopidogrel 75 mg in a 3-period (12 days each) blinded, crossover study in VE (n = 73; mean: 79 ± 3 years of age) or (n = 82) nonelderly (NE) (≥45 to

Original languageEnglish (US)
Pages (from-to)577-583
Number of pages7
JournalJournal of the American College of Cardiology
Volume62
Issue number7
DOIs
StatePublished - Aug 13 2013

    Fingerprint

Keywords

  • coronary artery disease
  • elderly
  • platelet reactivity
  • prasugrel

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Erlinge, D., Gurbel, P. A., James, S., Lindahl, T. L., Svensson, P., Ten Berg, J. M., Foley, D. P., Wagner, H., Brown, P. B., Luo, J., Zhou, C., Moser, B. A., Jakubowski, J. A., Small, D. S., Winters, K. J., & Angiolillo, D. J. (2013). Prasugrel 5 mg in the very elderly attenuates platelet inhibition but maintains noninferiority to prasugrel 10 mg in nonelderly patients: The GENERATIONS trial, a pharmacodynamic and pharmacokinetic study in stable coronary artery disease patients. Journal of the American College of Cardiology, 62(7), 577-583. https://doi.org/10.1016/j.jacc.2013.05.023