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New pathway could address clopidogrel resistance
December 2014
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LONDON—The antiplatelet drug clopidogrel (Plavix), together with aspirin, is a standard therapy for patients with coronary artery disease, acute coronary syndromes or those undergoing percutaneous coronary interventions. Unfortunately, clopidogrel resistance tends to present in 25 to 30 percent of Caucasians, with higher percentages in Asians. Poor responses to clopidogrel can be the result of polymorphisms in one or more of the cytochrome P450 enzymes, particularly CYP2C19. With their CEME data mining platform, McCormack Pharma has found new evidence of a previously unknown pathway that can bypass clopidogrel’s blocking of the P2Y12 platelet receptor. The company’s report suggests that upregulation of this pathway is controlled by a circulating marker that is elevated in some patients. Such patients could be identified by assay, and addressing the levels of the marker could be a solution for low-responding patients.
 
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