抗血小板新药替卡格雷取代氯吡格雷的探讨

Discussion on the substitution of ticagrelor for clopidogre

近年来,美国食品药品监督管理局(FDA)已经批准口服抗血小板药物替卡格雷配合使用低剂量阿司匹林,以降低急性冠脉综合征(ACS)血栓性心血管事件的发生率,替卡格雷将是氯吡格雷有力的竞争对手。虽然替卡格雷比氯吡格雷药效更好,但其存在用药依从性问题。另外,替卡格雷联合阿司匹林使用的剂量具有一个黑框警告,并且替卡格雷成本比氯吡格雷高得多。本文就两者的药物特征及临床治疗特点做进一步的阐述,分析成因。

Ticagrelor was approved by FDA as an oral antiplatelet drug in combination with low-dose aspirin to reduce the rate of thrombotic cardiovascular events in patients with acute coronary syndrome （ACS） and will become a strong competitor to clopidogrel. Ticagrelor has better efficacy than clopidogrel, but there is a problem in medication compliance. Besides, there is a black box warning on the doses of ticagrelor in combination with aspirin and the cost of ticagrelor is much higher than that of clopidogrel. This article describes the characteristics and the clinical features of both drugs and analyzes the causes of these differences.