clopidogrel / Generic mfg. - LARVOL DELTA

VERONICA: VerifyNow to Optimise Platelet Inhibition in Coronary Acute Syndrome (clinicaltrials.gov) - P4 | N=637 | Completed | Sponsor: Fundación EPIC | Trial completion date: Dec 2026 ➔ Aug 2026 | Trial primary completion date: Dec 2026 ➔ Jul 2026 | Active, not recruiting ➔ Completed

Trial completion • Trial completion date • Trial primary completion date • Acute Coronary Syndrome • Cardiovascular • Coronary Artery Disease • Myocardial Infarction

Gastrointestinal Bleeding Risk With Ibrutinib Versus Second Generation BTK Inhibitors in B-Cell Malignancies: A Large Real-World Cohort Analysis (ACG 2026) - "Newer second-generation BTK inhibitors are widely assumed to carry lower bleeding risk, but real-world comparative data on GI bleeding outcomes between first-generation (Ibrutinib) and second-generation BTK inhibitors (acalabrutinib, zanubrutinib) remains limited...Propensity score matching was performed on demographics, anticoagulant use, antiplatelets (aspirin, clopidogrel, ticagrelor), NSAIDs, thrombocytopenia, peptic ulcer disease, hemorrhoids, esophageal varices, liver disease, cirrhosis, and alcohol use... 3,653 patients per cohort were compared: composite GI hemorrhage (2.6% vs. 2.6%; RR 1.01, 95% CI 0.76-1.35; p=0.925; HR 1.04, p=0.663), melena (2.6% vs. 3.0%; p=0.333) and anorectal hemorrhage (1.5% vs."

Clinical • Real-world • Real-world evidence • Chronic Lymphocytic Leukemia • Fibrosis • Gastroenterology • Gastrointestinal Disorder • Hematological Malignancies • Hepatology • Immunology • Lymphoma • Lymphoplasmacytic Lymphoma • Mantle Cell Lymphoma • Oncology • Peptic Ulcer • Thrombocytopenia • Waldenstrom Macroglobulinemia

Analysis of marketing authorizations, withdrawals, and refusals by the European Medicines Agency (EMA): trends in approval procedures 1995-2025. (PubMed, Naunyn Schmiedebergs Arch Pharmacol) - "Among the active substances (International Nonproprietary Names, INNs) in centralized EMA MAPs, clopidogrel and denosumab are the most frequently represented. Our analysis shows that the development of centralized EMA MAPs is influenced by multiple factors such as medical need, regulatory framework, the economic potential of medicines, and patent law considerations. Our analysis provides a comprehensive overview of these procedures and may help identify potential obstacles and opportunities for their further development."

European regulatory • Journal • Oncology • Rare Diseases

Dual antithrombotic therapy with dabigatran and ticagrelor in patients with acute coronary syndrome and non-valvular atrial fibrillation undergoing percutaneous coronary intervention (ADONIS-PCI): protocol for a randomized controlled pilot trial. (PubMed, Cardiol J) - P4 | "ADONIS-PCI is among the first randomized evaluations of a reduced-dose long-term ticagrelor strategy combined with dabigatran in patients with AF and ACS undergoing PCI. The trial addresses an important evidence gap in the selection and dosing of P2Y12 inhibition when aspirin is discontinued early in this high-risk population."

Clinical protocol • Journal • Acute Coronary Syndrome • Atrial Fibrillation • Cardiovascular • Hematological Disorders • Myocardial Infarction

Opioid Analgesia in Acute Myocardial Infarction: Pharmacokinetic Interaction with P2Y12 Inhibitors and Pharmacodynamic Consequences-A Clinical Review for Emergency Physicians. (PubMed, J Emerg Med) - "In practice, pain relief should proceed alongside diagnosis and reperfusion. Nitroglycerin is appropriate when hemodynamics allow; an opioid is reasonable for severe pain that persists despite tolerated anti-ischemic therapy or when nitrates cannot be used. Small titrated doses, reassessment before redosing, and clear communication of opioid exposure, vomiting, shock, and P2Y12 loading time are more defensible than routine administration."

Journal • PK/PD data • Cardiovascular • Hematological Disorders • Myocardial Infarction • Pain • Thrombosis

Temporal Trends and Predictors of P2Y12 Inhibitor Selection and Switching Following Percutaneous Coronary Intervention in Acute Coronary Syndrome Patients. (PubMed, Am J Cardiovasc Drugs) - "In this real-world cohort of patients with ACS undergoing PCI, initial P2Y12 inhibitor selection varied by demographic, clinical, procedural, and geographic characteristics. Recorded ticagrelor-to-clopidogrel switching was common but should not be interpreted uniformly as intentional clinical de-escalation. These findings highlight the need for future research to clarify reasons for switching and to inform individualized P2Y12 inhibitor treatment strategies in routine practice."

Journal • Acute Coronary Syndrome • Cardiovascular • Myocardial Infarction

Postendoscopic Submucosal Dissection Bleeding Risk of Periprocedural Aspirin Maintenance Therapy in Clopidogrel Users as Single or Dual Antiplatelet Agents. (PubMed, Gut Liver) - "Periprocedural aspirin maintenance increased post-ESD bleeding within 2 weeks of gastric ESD. Resuming original clopidogrel therapy 2 weeks after ESD did not increase bleeding risk in patients receiving periprocedural aspirin maintenance therapy."

Journal • Cardiovascular • Gastric Cancer • Oncology • Solid Tumor

Cytochrome P450 Enzymes in the Metabolism of Proton Pump Inhibitors: Implications for the Treatment of Peptic Ulcers. (PubMed, Curr Drug Targets) - "Incorporating CYP2C19 genotyping and pharmacogenomic data into clinical decisionmaking may improve treatment individualization, although evidence remains heterogeneous and context-dependent."

Journal • Gastroenterology • Gastrointestinal Disorder • Infectious Disease • Metabolic Disorders • Peptic Ulcer • CYP2C19 • CYP3A4

Clopidogrel monotherapy versus aspirin monotherapy in females and males after percutaneous coronary intervention: a sex-stratified analysis of the SMART-CHOICE 3 trial. (PubMed, EuroIntervention) - "In patients with remote PCI and a high risk of recurrent ischaemic events, clopidogrel monotherapy showed a directionally consistent reduction in the composite endpoint of all-cause death, myocardial infarction, or stroke compared with aspirin in both females and males. No significant sex-by-treatment interaction was observed, supporting the consistency of the treatment effect across sexes."

Clinical • Journal • Monotherapy • Cardiovascular • Myocardial Infarction

Interaction between purinergic signalling and purinergic modulators with skin wound repair effectors: a systematic review of preclinical in vivo models. (PubMed, Purinergic Signal) - "Topical or oral administration of CGS-21680 (4-[{N-ethyl-5'-carbamoyladenos-2-yl}aminoethyl] phenylpropionic acid), UTP (Uridine-5'-triphosphate), NECA (5'-N-ethylcarboxamidoadenosine), ATP (adenosine triphosphate), PDRN (polydeoxyribonucleotide), ADP (Adenosine-5'-diphosphate) and TMPS (Thymidine 5'-O-monophosphorothioate) agonists stimulated wound contraction, fibroblast and keratinocyte proliferation, angiogenesis, and collagen biosynthesis...Conversely, the purinergic antagonists DMPX (3,7-dimethyl-1-propargylxanthine), CSC (8-(3-chlorostyryl) caffeine), SUR (Suramin), ENP (enprofylline), caffeine, CLOP (clopidogrel), MRS 2179 (2'-deoxy-N6-methyladenosine-3',5'-bisphosphate), and MRS 2395 (2-Chloro-3',5'-O-(benzoyl-β,γ-methylene) adenosine 5'-triphosphate), as well as genetic knockout for purinergic receptors delayed wound closure by inhibiting these pathways, impairing angiogenesis, collagenogenesis, and aggravating..."

Journal • Preclinical • Review • Inflammation • EGF • IL10 • IL13 • TGFB1

Potential Drug-Drug Interactions in Patients Undergoing Hemodialysis: A Retrospective Observational Study. (PubMed, Saudi Med J) - "In total, 4,157 pDDIs were identified, most of which were Category C (75.4%), followed by Categories B and D. Category X interactions were uncommon (n = 78), with clopidogrel-omeprazole and clopidogrel-esomeprazole being the most frequent. The pDDIs are highly prevalent among patients with ESRD undergoing HD, with polypharmacy identified as the main determinant. These findings highlight the importance of structured medication review, multidisciplinary collaboration, and clinical pharmacist involvement to reduce medication-related risks and optimize patient outcomes."

Journal • Observational data • Retrospective data • Chronic Kidney Disease • Nephrology • Renal Disease

Efficacy and safety of Xuesaitong soft capsule plus antiplatelet agents in ischemic stroke patients: a large-scale, multicenter, controlled, retrospective real-world study. (PubMed, Front Pharmacol) - "This multicenter, controlled, retrospective real-world study included 38,652 patients with ischemic stroke who received either antiplatelet agents (aspirin and/or clopidogrel) alone (control group, N = 37,249) or Xuesaitong soft capsule plus antiplatelet agents (observational group, N = 1,403)...The 1:4 PSM sensitivity analysis confirmed the robustness of the findings, with lower 1-year MACCE incidence in the observational group than in the control group (14.99% vs. 18.58%) (P = 0.002). Xuesaitong soft capsule combined with antiplatelet agents is associated with lower MACCE incidence and gastrointestinal adverse events compared to antiplatelet agents alone in ischemic stroke patients."

Journal • Real-world evidence • Retrospective data • Cardiovascular • Coronary Artery Disease • Dyslipidemia • Heart Failure • Hypertension • Ischemic stroke

Impact of antiplatelet therapy on erectile dysfunction following percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction. (PubMed, Front Med (Lausanne)) - "In male patients with STEMI, moderate-to-severe ED and bleeding episodes were common during DAPT. P2Y12 inhibitor type (ticagrelor vs. clopidogrel) and bleeding episodes were associated with moderate-to-severe ED."

Journal • Cardiovascular • Erectile Dysfunction • Myocardial Infarction • Pulmonary Disease

Suspected NIUAA after indobufen in a patient with ibuprofen allergy: a case report suggesting possible cross-reactivity. (PubMed, Front Pharmacol) - "Subsequent continued use of other concomitant medications, along with antiplatelet therapy with clopidogrel and cilostazol, did not elicit any allergic reactions; this case suggests indobufen as a possible culprit allergen, and its shared COX-1 inhibitory mechanism with ibuprofen-despite their different chemical groups-raises the possibility of cross-reactive hypersensitivity between the two agents, although this inference remains to be confirmed. Although allergic reactions to indobufen are rare in clinical practice, clinicians should remain vigilant about the potential risk of cross-reactivity when prescribing indobufen to patients with a history of NSAID hypersensitivity."

Journal • Allergy • CNS Disorders • Dermatology • Immunology • Pruritus

Development and validation of a clinical-pharmacogenomic prediction model for clopidogrel-related high on-treatment platelet reactivity in patients with coronary artery disease. (PubMed, Front Cardiovasc Med) - "This study developed and internally validated a clinical-pharmacogenomic prediction model for clopidogrel-related HPR in CAD patients. The model demonstrated promising performance; however, external validation in multicenter prospective cohorts is required before clinical implementation."

Biomarker • Journal • Acute Coronary Syndrome • Cardiovascular • Coronary Artery Disease • CYP2C19

Prasugrel in the management of acute coronary syndromes: a systematic review. (PubMed, Daru) - "In eligible ACS patients proceeding to intervention, prasugrel is the preferred or co-preferred P2Y12 inhibitor in contemporary European and American guidelines. Platelet function testing-guided de-escalation to clopidogrel provides a validated alternative strategy for patients at elevated bleeding risk during the maintenance phase of therapy."

Journal • Review • Acute Coronary Syndrome • Cardiovascular

Comparison of antiplatelet treatment in patients with clopidogrel nonresponders with or without carriage of CYP2C19 polymorphism. (PubMed, Korean J Intern Med) - No abstract available

Journal • CYP2C19

Retrospective evaluation of outcomes in dogs with non-associative immune-mediated haemolytic anaemia treated with rivaroxaban as a sole or adjunctive thromboprophylaxis agent: 34 cases (2018-2024). (PubMed, J Small Anim Pract) - "This represents one of the largest UK-based cohorts of dogs with non-associative immune-mediated haemolytic anaemia treated with rivaroxaban, demonstrating acceptable survival and remission rates with this thromboprophylaxis protocol. The occurrence of clinically significant gastrointestinal bleeding exclusively in dogs receiving concurrent corticosteroids, mycophenolate mofetil and rivaroxaban represents an important safety signal that warrants consideration and further study."

Journal • Retrospective data • Anemia • Cardiovascular • Gastroenterology • Hematological Disorders

VerifyNow in acute coronary syndrome: design of the EPIC17-VERONICA trial to optimize platelet inhibition. (PubMed, REC Interv Cardiol) - P4 | "De-escalation from prasugrel and ticagrelor to clopidogrel in patients undergoing percutaneous coronary intervention after acute coronary syndrome (ACS) is a strategy aimed at reducing bleeding. The EPIC17-VERONICA study (NCT04654052) will reveal the efficacy profile of the de-escalation strategy, based on the VerifyNow platelet aggregation test, and determine the role of this device in the selection of patients who are eligible to benefit from this strategy. This study will determine whether platelet function testing provide clinical benefit in the management of patients with ACS."

Journal • Acute Coronary Syndrome • Cardiovascular • Myocardial Infarction

STELAR: Short-Term Dual Antiplatelet Therapy With Early Transi-tion to Low-dose Antiplatelet Monotherapy Using Ti-cagRelor in Chronic Coronary Artery Disease (clinicaltrials.gov) - P4 | N=1000 | Not yet recruiting | Sponsor: University of Messina | Trial completion date: Sep 2027 ➔ Sep 2028 | Trial primary completion date: Dec 2026 ➔ Dec 2027

Monotherapy • Trial completion date • Trial primary completion date • Cardiovascular • Coronary Artery Disease

Clopidogrel or Aspirin for Long-Term Secondary Prevention in Patients With Diabetes: What Is the Smartest Choice? (PubMed, JACC Cardiovasc Interv) - No abstract available

Journal • Cardiovascular • Diabetes • Metabolic Disorders

Does residual ADP reactivity within the therapeutic range predict intraoperative thromboembolic events during endovascular treatment of intracranial aneurysms? (PubMed, Neuroradiology) - "In this cohort of 196 patients with adequate preoperative platelet inhibition, residual ADP-induced platelet reactivity was not associated with the risk of intraoperative thromboembolic complications. These findings suggest that residual ADP reactivity within the therapeutic range has limited value for predicting intraoperative thromboembolic events."

Journal • Cardiovascular • Hematological Disorders • Subarachnoid Hemorrhage • Thrombosis • Vascular Neurology

Temporary interruption versus continuation of clopidogrel in patients undergoing colonoscopy with polypectomy: a systematic review and meta-analysis. (PubMed, Surg Endosc) - "Temporary interruption of clopidogrel before colonoscopy with small-polyp polypectomy, most commonly using cold snare techniques, reduced the risk of immediate PPB without significantly increasing delayed bleeding and cardioembolic events. However, additional large-scale RCTs are needed to confirm these findings and guide optimal periprocedural management."

Journal • Retrospective data • Colorectal Cancer • Oncology • Solid Tumor

Association Between CYP2C19 Genotype and P2Y12 Reaction Units in Patients Receiving Clopidogrel After Acute Ischemic Stroke: A Prospective, Observational Study. (PubMed, Pharmacotherapy) - "PRUs appear to vary by CYP2C19 genotype in patients receiving DAPT after minor AIS or TIA, suggesting utility as a surrogate marker of clopidogrel nonresponse when genotyping is unavailable. However, PRUs were not associated with short-term clinical outcomes."

Journal • Observational data • Cardiovascular • Ischemic stroke • CYP2C19

High-Intensity Statins and the Post-Discharge Clinical Outcomes at 1 Year After Percutaneous Coronary Intervention: Insights From STOPDAPT-3. (PubMed, Circ Rep) - "We performed a post hoc analysis of STOPDAPT-3, which compared 1-month aspirin-free prasugrel monotherapy followed by clopidogrel monotherapy with 1-month dual antiplatelet therapy (DAPT) followed by aspirin monotherapy in patients with ACS or a high bleeding risk undergoing PCI. High-intensity statins were defined as the maximum approved dose of strong statins in Japan (e.g., rosuvastatin 10 mg, atorvastatin 20 mg, or pitavastatin 4 mg)...The 1-year post-discharge cumulative incidence of cardiovascular events was similar between patients who received high-intensity statins and those who did not (3.90% vs. 4.27%, P=0.51; adjusted HR 1.03; 95% CI 0.74-1.44; P=0.84). In STOPDAPT-3, high-intensity statin therapy at discharge was not associated with a reduced risk of cardiovascular events 1 year after PCI, under the limitations of having no laboratory test or prescription data available during the follow up."

Clinical data • Journal • Acute Coronary Syndrome • Cardiovascular • Coronary Artery Disease • Dyslipidemia