The antiplatelet drug Plavix (clopidogrel) should be given before rather than at the time of coronary angioplasty procedures, according to a clinical study presented at the European Society of Cardiology meeting in Stockholm, Sweden.

The results of the PCI-CLARITY study suggest that early use of clopidogrel - hours or days before angioplasty - is associated with a 45% reduction in death, heart attack or stroke compared to when the drug was given at the same time as the procedure, according to the researchers, from Brigham & Women’s Hospital in Boston, USA. Plavix is sold by France’s Sanofi-Aventis and US drugmaker Bristol-Myers Squibb.

The study should lay to rest speculation about the optimal timing of clopidogrel in patients undergoing angioplasty procedures, according to the clinicians, who told the conference that giving the drug as a pre-treatment also reduced the odds of a recurrent heart attack or stroke while patients were waiting for angioplasty by 38%.

Plavix is already Sanofi-Aventis’ second biggest-selling drug and the fourth-ranked product in the world with first-half 2005 sales of nearly 1 billion euros. Widespread adoption of the regimen in PCI-CLARITY, which involves one to three extra doses of the drug per procedure, would help maintain this growth. However, the drug remains under the threat of generic competition, with patent disputes going through the law courts [[01/05/05d]], [[08/08/05c]].

The study’s results are published online on the Journal of the American Medical Association website, and will be published in the print journal on September 14.

PCI-CLARITY was a subgroup of the CLARITY-TIMI 28 trial, reported in the New England Journal of Medicine earlier this year, which demonstrated that clopidogrel helped open blocked arteries and decreased the odds of a second heart attack by 31% [[10/03/05b]].