Medco study suggests PPIs inhibit B-MS' Plavix

USA-based pharmacy benefits management group Medco Health Solutions presented a study showing an increased risk for major cardiovascular events in patients taking proton pump inhibitors together with Bristol-Myers Squibb and Sanofi-Aventis' Plavix (clopidogrel) at the scientific sessions of the American Heart Association, held in New Orleans.

Medco researchers tracked 16,690 patients who had undergone a percutaneous coronary intervention, such as stent placement or balloon angioplasty, and had started taking clopidogrel as maintenance therapy. Of the subjects, 9,862 were taking clopidogrel alone and 6,828 clopidogrel and a PPI. Researchers tracked the two groups in the study for a 12-month period using medical and pharmacy claims data. The relative risk of a major adverse cardiovascular event was 50% higher, and the danger of a heart attack specifically was 74% greater, in patients taking both medications together. The incidence of a major cardiovascular event within 12 months of starting clopidogrel therapy was 25% for those taking both medications.

"Considering the widespread use of these two medications, this important research adds to a growing body of evidence raising questions about their concurrent use and suggests further research is needed," said Robert Epstein, lead study author and chief medical officer at Medco. "With this research in hand, we intend to open a dialog with the major clinical organizations to advance the discussion around the guidelines that govern the use of Plavix," he added.