2011 July - December - nuhcs

The new P2Y12 – inhibiiting drugs, Ticagrelor (Brillianta,Astrat Zeneca) and Prasugrel (Effient, Eli-Lilly) reduce plateletstickiness more effectively and consistently in part because theybypass the CYP2C19 system of drug activation. Not only are thesenew drugs more expensive than clopidogrel, which is presentlygeneric, they can cause increased bleeding, so they may not besuitable for every patient.One possibility to do genetic testing to determine whichpatients may require the newer P2Y12 drugs. However, genetictesting itself can be expensive. Moreover, there are many otherdeterminants of response to clopidogrel, including age, bodyweight, renal function and diabetes. There is also the question ofwhether measuring the actual stickiness of the platelet itself, calledplatelet reactivity testing, is a better alternative.One of the symposium highlights was a hands-on plateletfunction testing workshop in which participants were trained inthe performance and interpretation of genetic tests and plateletreactivity tests.The APS meeting will be held every two years at differentlocations in South-east Asia. Through these meetings, Drs Chanand Chee hope to highlight and address some of the uncertaintiesin the use of these antithrombotic medications drugs and also equiphealthcare providers with practical yet thoughtful strategies fortreating patients with venous and arterial thrombotic disorders.NUHCS PULSE | 19