Randomized double-blind assessment of the ONSET and OFFSET of the antiplatelet effects of ticagrelor versus clopidogrel in patients with stable coronary artery disease: The ONSET/OFFSET study

Paul A. Gurbel, Kevin P. Bliden, Kathleen Butler, Udaya S. Tantry, Tania Gesheff, Cheryl Wei, Renli Teng, Mark J. Antonino, Shankar B. Patil, Arun Karunakaran, Dean J. Kereiakes, Cordel Parris, Drew Purdy, Vance Wilson, Gary S. Ledley, Robert F. Storey

Research output: Contribution to journalArticle

Abstract

BACKGROUND-: Ticagrelor is the first reversibly binding oral P2Y12 receptor antagonist. This is the first study to compare the onset and offset of platelet inhibition (IPA) with ticagrelor using the PLATO (PLATelet inhibition and patient Outcomes) trial loading dose (180 mg) with a high loading dose (600 mg) of clopidogrel. METHODS AND RESULTS-: In a multicenter, randomized, double-blind study, 123 patients with stable coronary artery disease who were taking aspirin therapy (75 to 100 mg/d) received ticagrelor (180-mg load, 90-mg BID maintenance dose [n=57]), clopidogrel (600-mg load, 75-mg/d maintenance dose [n=54]), or placebo (n=12) for 6 weeks. Greater IPA (20 μmol/L ADP, final extent) occurred with ticagrelor than with clopidogrel at 0.5, 1, 2, 4, 8, and 24 hours after loading and at 6 weeks (P50% IPA (98% versus 31%, P70% IPA (90% versus 16%, P

Original languageEnglish (US)
Pages (from-to)2577-2585
Number of pages9
JournalCirculation
Volume120
Issue number25
DOIs
StatePublished - Dec 2009

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clopidogrel
Coronary Artery Disease
Purinergic P2Y Receptor Antagonists
Blood Platelets
Double-Blind Method
Adenosine Diphosphate
Aspirin
Placebos
Ticagrelor

Keywords

  • Antiplatelet agents
  • Clopidogrel
  • Platelets
  • Ticagrelor

ASJC Scopus subject areas

  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Cite this

Randomized double-blind assessment of the ONSET and OFFSET of the antiplatelet effects of ticagrelor versus clopidogrel in patients with stable coronary artery disease : The ONSET/OFFSET study. / Gurbel, Paul A.; Bliden, Kevin P.; Butler, Kathleen; Tantry, Udaya S.; Gesheff, Tania; Wei, Cheryl; Teng, Renli; Antonino, Mark J.; Patil, Shankar B.; Karunakaran, Arun; Kereiakes, Dean J.; Parris, Cordel; Purdy, Drew; Wilson, Vance; Ledley, Gary S.; Storey, Robert F.

In: Circulation, Vol. 120, No. 25, 12.2009, p. 2577-2585.

Research output: Contribution to journalArticle

Gurbel, PA, Bliden, KP, Butler, K, Tantry, US, Gesheff, T, Wei, C, Teng, R, Antonino, MJ, Patil, SB, Karunakaran, A, Kereiakes, DJ, Parris, C, Purdy, D, Wilson, V, Ledley, GS & Storey, RF 2009, 'Randomized double-blind assessment of the ONSET and OFFSET of the antiplatelet effects of ticagrelor versus clopidogrel in patients with stable coronary artery disease: The ONSET/OFFSET study', Circulation, vol. 120, no. 25, pp. 2577-2585. https://doi.org/10.1161/CIRCULATIONAHA.109.912550
Gurbel, Paul A. ; Bliden, Kevin P. ; Butler, Kathleen ; Tantry, Udaya S. ; Gesheff, Tania ; Wei, Cheryl ; Teng, Renli ; Antonino, Mark J. ; Patil, Shankar B. ; Karunakaran, Arun ; Kereiakes, Dean J. ; Parris, Cordel ; Purdy, Drew ; Wilson, Vance ; Ledley, Gary S. ; Storey, Robert F. / Randomized double-blind assessment of the ONSET and OFFSET of the antiplatelet effects of ticagrelor versus clopidogrel in patients with stable coronary artery disease : The ONSET/OFFSET study. In: Circulation. 2009 ; Vol. 120, No. 25. pp. 2577-2585.
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abstract = "BACKGROUND-: Ticagrelor is the first reversibly binding oral P2Y12 receptor antagonist. This is the first study to compare the onset and offset of platelet inhibition (IPA) with ticagrelor using the PLATO (PLATelet inhibition and patient Outcomes) trial loading dose (180 mg) with a high loading dose (600 mg) of clopidogrel. METHODS AND RESULTS-: In a multicenter, randomized, double-blind study, 123 patients with stable coronary artery disease who were taking aspirin therapy (75 to 100 mg/d) received ticagrelor (180-mg load, 90-mg BID maintenance dose [n=57]), clopidogrel (600-mg load, 75-mg/d maintenance dose [n=54]), or placebo (n=12) for 6 weeks. Greater IPA (20 μmol/L ADP, final extent) occurred with ticagrelor than with clopidogrel at 0.5, 1, 2, 4, 8, and 24 hours after loading and at 6 weeks (P50{\%} IPA (98{\%} versus 31{\%}, P70{\%} IPA (90{\%} versus 16{\%}, P",
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T2 - The ONSET/OFFSET study

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AU - Bliden, Kevin P.

AU - Butler, Kathleen

AU - Tantry, Udaya S.

AU - Gesheff, Tania

AU - Wei, Cheryl

AU - Teng, Renli

AU - Antonino, Mark J.

AU - Patil, Shankar B.

AU - Karunakaran, Arun

AU - Kereiakes, Dean J.

AU - Parris, Cordel

AU - Purdy, Drew

AU - Wilson, Vance

AU - Ledley, Gary S.

AU - Storey, Robert F.

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N2 - BACKGROUND-: Ticagrelor is the first reversibly binding oral P2Y12 receptor antagonist. This is the first study to compare the onset and offset of platelet inhibition (IPA) with ticagrelor using the PLATO (PLATelet inhibition and patient Outcomes) trial loading dose (180 mg) with a high loading dose (600 mg) of clopidogrel. METHODS AND RESULTS-: In a multicenter, randomized, double-blind study, 123 patients with stable coronary artery disease who were taking aspirin therapy (75 to 100 mg/d) received ticagrelor (180-mg load, 90-mg BID maintenance dose [n=57]), clopidogrel (600-mg load, 75-mg/d maintenance dose [n=54]), or placebo (n=12) for 6 weeks. Greater IPA (20 μmol/L ADP, final extent) occurred with ticagrelor than with clopidogrel at 0.5, 1, 2, 4, 8, and 24 hours after loading and at 6 weeks (P50% IPA (98% versus 31%, P70% IPA (90% versus 16%, P

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