prasugrel / 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

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

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

Pooled Prasugrel Doses in a P2Y12 Network Meta-Analysis. (PubMed, JAMA Cardiol) - No abstract available

Journal • Retrospective data

Pooled Prasugrel Doses in a P2Y12 Network Meta-Analysis-Reply. (PubMed, JAMA Cardiol) - No abstract available

Journal • Retrospective data

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

Ultrashort vs Standard-Duration Dual Antiplatelet Therapy in Acute Coronary Syndrome Patients Undergoing PCI: A Meta-Analysis. (PubMed, JACC Cardiovasc Interv) - "In patients with ACS undergoing PCI, ultrashort DAPT reduced bleeding without increasing ischemic events overall, although a signal of increased MACCE was observed in STEMI but not in NSTE-ACS. Bleeding reduction was greater in East Asians, while ≤1-week DAPT or clopidogrel/aspirin monotherapy may increase ischemic risk."

Clinical • Journal • Retrospective data • Review • Acute Coronary Syndrome • Cardiovascular • Myocardial Infarction

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

One-Month Outcomes of Aspirin-Free Strategy for Percutaneous Coronary Intervention With or Without Proton-Pump Inhibitors: A Post Hoc Subgroup Analysis of STOPDAPT-3. (PubMed, Circ Rep) - "For the cardiovascular endpoint, there was a lower risk of no aspirin relative to DAPT in the no PPI subgroup (0.41% vs. 3.27%; HR 0.13; 95% CI 0.03-0.60), but not in the PPI subgroup (HR 1.29; 95% CI 0.86-1.93) with a significant interaction (P interaction=0.005). There was no interaction for bleeding between PPI prescription and antiplatelet regimen, but a significant interaction for cardiovascular events, requiring cautious interpretation due to the small no-PPI subgroup and baseline imbalances."

Journal • Retrospective data • Cardiovascular • Hematological Disorders • Ischemic stroke • Myocardial Infarction • Thrombosis

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

Repurposing Prasugrel: A Neuroprotective Strategy Against Pentylenetetrazol-Induced Kindling in Mice. (PubMed, Eur J Pharmacol) - "The current study suggests that prasugrel exhibits neuroprotective effects in the PTZ-induced kindling model, via modulating the P2Y12 receptor mediated neuroinflammatory and apoptotic pathways. These findings support the repurposing of prasugrel as a promising therapeutic approach for the treatment of epilepsy."

Journal • Preclinical • CNS Disorders • Epilepsy • Inflammation • CASP3 • CASP8 • IL1B • TNFA

Comparative Safety and Efficacy of Dual Antiplatelet Therapy Regimens in Flow Diversion for Intracranial Aneurysms: a Systematic Review and Network Meta-Analysis. (PubMed, Clin Neuroradiol) - "Current FD-specific evidence is insufficient to establish superiority, inferiority, or equivalence among clopidogrel-, ticagrelor-, and prasugrel-based DAPT regimens across ischemic, hemorrhagic, functional, and survival outcomes. Because treatment allocation was non-random and alternative regimens were preferentially used in patients with suspected clopidogrel hyporesponsiveness, these findings should not be read as supporting a clopidogrel-first hierarchy; regimen selection is likely to remain guided by local pharmacogenetic testing, and cost considerations pending higher-quality comparative data."

Journal • Retrospective data • Review • Cardiovascular • Hematological Disorders • Vascular Neurology

STREAMLINE: Dual Antiplatelet Therapy Strategies After Acute Myocardial Infarction Undergoing PCI: Prasugrel vs Ticagrelor & 12 Months vs 1-3 Months (clinicaltrials.gov) - P4 | N=8100 | Recruiting | Sponsor: Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz | Not yet recruiting ➔ Recruiting

Enrollment open • Acute Coronary Syndrome • Cardiovascular • Myocardial Infarction

Comparative Effectiveness and Safety of Prasugrel versus Ticagrelor After Percutaneous Coronary Intervention - A Real-World Cohort Study (AHA 2026) - "Abstract is embargoed at this time."

Clinical • HEOR • Real-world • Real-world evidence • Cardiovascular

Rare delayed thromboembolic complication 18 days after Woven EndoBridge implantation: A case report. (PubMed, Surg Neurol Int) - "Aspirin (200 mg) and prasugrel (20 mg) with systemic heparinization were promptly initiated, resulting in complete thrombus resolution. Delayed TEC can occur beyond the immediate periprocedural period after WEB treatment. Short-term postoperative antiplatelet therapy may be beneficial even after apparently uncomplicated WEB implantation."

Journal • Cardiovascular • Thrombosis

Clinical practice of cangrelor use in Austrian ACS patients: a real-world multicenter registry. (PubMed, Front Cardiovasc Med) - "Overall, 69% of patients received aspirin and heparin alone, whereas 31% also received an oral P2Y12 inhibitor before cangrelor initiation. Among patients transitioned to a thienopyridine, 9 (6%) received clopidogrel and 6 (4%) received prasugrel before cangrelor discontinuation. Major bleeding (BARC ≥3) occurred in 46 patients (7%), without observed differences according to the timing of oral P2Y12 inhibitor administration. This nationwide real-world study highlights considerable variability in the clinical use of Cangrelor and its integration with oral P2Y12 inhibitors."

Journal • Real-world evidence • Acute Coronary Syndrome • Cardiovascular

Comparative evaluation of anti-inflammatory and antioxidant effects of prasugrel versus clopidogrel in patients undergoing percutaneous coronary intervention: A prospective cohort study. (PubMed, Indian J Pharmacol) - "Prasugrel-based DAPT showed significantly greater reduction in inflammation compared to clopidogrel-based DAPT, with comparable antioxidant benefit and hematological safety indicating a greater pleiotropic benefit of prasugrel than clopidogrel."

Clinical • Journal • Acute Coronary Syndrome • Cardiovascular • Hematological Disorders • Inflammation • CRP

Ticagrelor versus Prasugrel in Patients Undergoing Invasive Management of Coronary Artery Disease (ESC 2026) - No abstract available

Clinical • Late-breaking abstract • Cardiovascular • Coronary Artery Disease

SWITCH SWEDEHEART - Switching from ticagrelor to prasugrel in patients with ACS (ESC 2026) - No abstract available

Clinical • Cardiovascular

Use and costs of P2Y12 inhibitors after myocardial infarction in germany and the US (ESC 2026) - "In randomized trials, the potent P2Y12 inhibitors ticagrelor and prasugrel reduced ischemic events compared with clopidogrel. Earlier and greater adoption of prasugrel in Germany after 2019 contrasted with continued predominant use of ticagrelor in the US after randomized trials suggested prasugrel’s superiority over ticagrelor. Greater uptake of prasugrel in the US may have reduced drug spending without compromising post-myocardial infarction care."

Cardiovascular • Myocardial Infarction

Organ-specific bleeding patterns under potent P2Y12 inhibition and triple therapy: mechanistic insights from a 24-month post-percutaneous coronary intervention cohort. (ESC 2026) - " Out of an initial 453-patient cohort, we analyzed 410 consecutive patients post-PCI (DAPT-Clopidogrel [DAPT-C]: n=93; DAPT-Prasugrel [DAPT-P]: n=286; Triple Antithrombotic Therapy [TAT]: n=31) who completed a 24-month clinical follow-up period. Our findings suggest that the choice of antithrombotic therapy is a more dominant driver of major bleeding than age or hypertension in the post-PCI setting. These results align with safety signals from the AUGUSTUS and AFIRE trials. Mechanistically, potent P2Y12 inhibition significantly reduces the activation of glycoprotein IIb/IIIa receptors, impairing the final common pathway of platelet aggregation."

Cardiovascular • Hypertension

Efficacy and safety of prasugrel monotherapy compared with clopidogrel in Japanese patients with acute coronary syndrome after percutaneous coronary intervention (ESC 2026) - "Among stabilized ACS patients in whom follow-up began at the later of 6 months after PCI and transition to SAPT, adjusted-dose prasugrel monotherapy was associated with lower ischemic and net adverse clinical events compared with clopidogrel monotherapy. Large-scale randomized controlled trials are warranted to confirm these findings."

Clinical • Monotherapy • Acute Coronary Syndrome • Cardiovascular • Myocardial Infarction • Thrombosis

Profilin 1 is associated with markers of platelet reactivity and hypofibrinolysis in chronic coronary syndrome (ESC 2026) - "All patients and controls were taking 75mg acetylsalicylic acid at the time of blood collection...Patients on ASA + ticagrelor/prasugrel had 45% lower Pfn1 as compared to those on ASA only (0.6 [0.4-0.9] vs. 1.1 [0.7-1.8] ng/ml, p = 0.0014) and 40% lower as compared with those on the ASA + clopidogrel regimen (0.6 [0.4-0.9] vs. 1.0 [0.7-1.4] ng/ml, p = 0.0096, Fig...The robust correlation between Pfn1 and sCD40L could indicate a link between Pfn1 and platelet-driven inflammatory activity. This intriguing notion requires further investigation."

IO biomarker • Atherosclerosis • Cardiovascular • Myocardial Infarction • CD40LG • CRP

Comparison of oxidative and tissue stress biomarkers and platelet activation in myocardial infarction treated with prasugrel or ticagrelor (ESC 2026) - "In the whole study population, thioredoxin-1 correlated with soluble P-selectin (Spearman ρ=0.59).ConclusionsIn this randomized study of AMI patients undergoing pPCI, no differences in oxidative stress, tissue/inflammatory stress, or platelet activation were observed between prasugrel- and ticagrelor treatment, suggesting similar biological effects beyond platelet aggregation. The observed association between thioredoxin-1 and soluble P-selectin indicate a link between redox activity and platelet activation in AMI, independent of treatment."

Biomarker • Cardiovascular • Myocardial Infarction • GDF15 • IL33 • SOD3

Potent P2Y12 inhibitor monotherapy without aspirin early after percutaneous coronary intervention: the NEO-MINDSET Platelet Function Substudy (ESC 2026) - "In both groups, only prasugrel or ticagrelor were allowed, which were chosen at investigator discretion. Among patients undergoing successful PCI for ACS receiving monotherapy without aspirin, platelet function was inhibited in response to ADP at both pre- and post-dose, which suggests that potent P2Y12 inhibitor effects are preserved at trough. Conversely, platelet inhibition was greater with DAPT than monotherapy when agonists targeted to the cyclooxygenase-1 pathway were used."

Monotherapy • Acute Coronary Syndrome • Cardiovascular