Eli Lilly says study shows prasugrel superior in antiplatelet effect to Plavis

By Ted A. Knutson

Washington, March 14 - Ely Lilly & Co. said Tuesday early phase 1b data shows an investigational antiplatelet agent, prasugrel, demonstrated greater and more reliable antiplatelet effect compared to clopidogrel (Plavis) even in patients with increased platelet reactivity.

These data were featured in one of several prasugrel presentations at the 2006 Scientific Sessions of the American College of Cardiology in Atlanta.

Prasugrel is an investigational antiplatelet agent designed to prevent platelet activation and aggregation by blocking adenosine diphosphate receptors on the platelet surface.

In a phase 1b study, greater than 90% of prasugrel-treated patients achieved greater than 20% inhibition of platelet aggregation (IPA), compared with less than 50% of clopidogrel-treated patients. The study showed that even patients with more reactive platelets at baseline, a population whose platelets may be less affected or unaffected by current thienopyridine therapies, have higher and more consistent inhibition of platelet aggregation with prasugrel than with clopidogrel.

In a second study, prasugrel was shown to produce rapid, potent and consistent inhibition of both platelet activation and generation of thrombo-inflammatory markers.

Notably, the inhibitory effect of prasugrel was independent of the effects of aspirin. Moreover, the study results suggest that pre-treatment with aspirin is not required for prasugrel blockade of ADP-induced platelet activation.

Eli Lilly and Sankyo Co. Ltd., a subsidiary of Daiichi Sankyo Co. Ltd., are developing prasugrel, an oral antiplatelet agent, as a potential treatment for patients who have suffered a heart attack or unstable angina (heart-related chest pain).

Antiplatelet agents are used both acutely and as maintenance therapy to inhibit platelet activation and aggregation that occur in diseased arteries and in response to invasive procedures such as percutaneous coronary intervention, a procedure to open blockages in heart arteries that includes the use of coronary stents. Antiplatelet agents prevent platelets from clumping or sticking together, which can cause formation of blood clots and lead to heart attack or stroke.

Recent studies suggest that a relationship may exist between a poor platelet response to antiplatelet agents in individual patients and poor clinical outcomes, which manifest as major adverse cardiovascular events, including heart attacks.

Based in Indianapolis, Eli Lilly is developing a growing portfolio of pharmaceutical products by applying research from its own worldwide laboratories and from collaborations with scientific organizations.

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