Robert, I am sure most posters are aware of this but am reposting:
clinical-cardiology.org
"Abciximab shows irreversible binding to the GP IIb-IIIa receptor and a prolonged
hemostatic effect. Integrilin, on the other hand, is highly specific for the GP IIb-IIIa receptor, does not
elicit immune response, and has not had any significant side effects so far. Furthermore, binding of
Integrilin to the GP IIb-IIIa receptor is rapidly reversible, and hemostatic effects are limited to the period of
administration of Integrilin. These properties may lead to the preferential clinical use of Integrilin,
particularly in patients who have already received abciximab and require a secondary revascularization."
AND
clinical-cardiology.org
It should be noted that the dosing regimens in IMPACT II were based on pharmacodynamic studies that
did not adequately reflect the extent of suppression of platelet aggregation. This is attributed to
subsequent ex vivo platelet studies performed after IMPACT II that showed an artifact due to previous
collection of samples on citrate, leading to chelation of the GP IIb-IIIa receptor. As a result, the doses of
Integrilin used in this study were suboptimal, achieving far less than 80% receptor occupancy. Based on
this new knowledge and novel platelet aggregation assays, the dosing in subsequent studies was
increased to achieve 85 to 90% receptor blockade, similar to that achieved with therapeutic doses of
abciximab. |
