Prasugrel plus aspirin cuts risk of ST vs gold standard

Japanese drugmaker Daiichi Sankyo and US drug major Eli Lilly say that their investigational antiplatelet drug prasugrel plus aspirin produced a marked and highly statistically-significant reduction in the risk of coronary stent thrombosis compared to standard therapy. The data were presented at the American College of Cardiology's 57th Annual Scientific Session in Chicago.

According to a stent analysis from the head-to-head TRITON-TIMI 38 trial, the novel combination is more effective than Sanofi-Aventis' blockbuster Plavix (clopidogrel) plus aspirin (1.13% versus 2.35%, p<0.0001). Prasugrel reduced the relative risk of coronary stent thrombosis by 52% (1.13% vs 2.35%, p<0.0001). In patients who received drug-eluting stents, treatment with prasugrel reduced relative risk by 64% over clopidogrel (0.84% vs 2.31%, p<0.0001), and by 48% in patients who received bare metal stents (1.27% vs 2.41%, p=0.0009).

Indianapolis-headquartered Lilly is hoping that the Daiichi Sankyo-originated drug will help it recoup losses as US patents on several of its key products expire over the next few years. In 2011, the firm will lose exclusivity on its top earner, the antipsychotic Zyprexa (olanzapine), which had peak annual domestic sales of $2.6 billion. Another key drug, Actos (pioglitazone), an antidiabetic co-developed with Takeda and Watson Pharmaceuticals, with peak US revenues of $4.4 billion, also faces patent expiration in 2011. Prasugrel's main rival, Plavix, was the world's fourth highest-selling drug in the 12 months to August 2007 (Marketletter October 22), earning almost $6.0 billion in global sales last year.