A double-blind, randomized, multicenter phase 2 study of prasugrel versus placebo in adult patients with sickle cell disease.

Published online

Journal Article

BACKGROUND: Platelet activation has been implicated in the pathogenesis of sickle cell disease (SCD) suggesting antiplatelet agents may be therapeutic. To evaluate the safety of prasugrel, a thienopyridine antiplatelet agent, in adult patients with SCD, we conducted a double-blind, randomized, placebo-controlled study. METHODS: The primary endpoint, safety, was measured by hemorrhagic events requiring medical intervention. Patients were randomized to prasugrel 5 mg daily (n = 41) or placebo (n = 21) for 30 days. Platelet function by VerifyNow® P2Y12 and vasodilator-stimulated phosphoprotein assays at days 10 and 30 were significantly inhibited in prasugrel- compared with placebo-treated SCD patients. RESULTS: There were no hemorrhagic events requiring medical intervention in either study arm. Mean pain rate (percentage of days with pain) and intensity in the prasugrel arm were decreased compared with placebo. However, these decreases did not reach statistical significance. Platelet surface P-selectin and plasma soluble P-selectin, biomarkers of in vivo platelet activation, were significantly reduced in SCD patients receiving prasugrel compared with placebo. In sum, prasugrel was well tolerated and not associated with serious hemorrhagic events. CONCLUSIONS: Despite the small size and short duration of this study, there was a decrease in platelet activation biomarkers and a trend toward decreased pain.

Full Text

Duke Authors

Cited Authors

  • Wun, T; Soulieres, D; Frelinger, AL; Krishnamurti, L; Novelli, EM; Kutlar, A; Ataga, KI; Knupp, CL; McMahon, LE; Strouse, JJ; Zhou, C; Heath, LE; Nwachuku, CE; Jakubowski, JA; Riesmeyer, JS; Winters, KJ

Published Date

  • February 17, 2013

Published In

Volume / Issue

  • 6 /

Start / End Page

  • 17 -

PubMed ID

  • 23414938

Pubmed Central ID

  • 23414938

Electronic International Standard Serial Number (EISSN)

  • 1756-8722

Digital Object Identifier (DOI)

  • 10.1186/1756-8722-6-17

Language

  • eng

Conference Location

  • England