September 20th, 2010
Encouraging Observational Data on Clopidogrel and PPIs
Compared with a PPI alone, the combination of clopidogrel and a PPI does not increase risk for cardiovascular events, according to a large observational study from Denmark published in the Annals of Internal Medicine. Mette Charlot and colleagues analyzed data from 56,406 Danish patients discharged after a first MI and found no difference between the treatments in the rate of cardiovascular death or rehospitalization for MI or stroke.
In an accompanying editorial, Joao Paulo de Aquino Lima and James Brophy are critical of current warnings about PPI/clopidogrel interactions because they “are based on a paucity of quality clinical studies and instead have relied more on in vitro platelet-inhibition studies.” They conclude that “unbiased science should be the final arbiter in determining the risk for any putative drug interaction, but the modulating role that the social, cultural, economic, and political context in which medicine and clinical research is practiced should be appreciated.”