CAPRIE研究.ppt

* 幻灯片23 CAPRIE研究的不良事件率提示除了腹泻和皮疹以外1，波立维的副反应比阿司匹林少。严重腹泻和皮疹的发生率低，无重要临床意义。这些事件的发生率也比已发表的噻氯匹定要低2。 CAPRIE研究还分析了波立维对中性粒细胞数变化的影响。结果显示波立维组和阿司匹林组中性粒细胞减少（中性粒细胞1.2x109个/升）和严重中性粒细胞减少（ (0.45x109个/升）的比例相似1。 不能耐受阿司匹林（例如有消化性溃疡出血史）的患者，被CAPRIE研究排除。然而，在CAPRIE研究人群中，溃疡3和胃肠道出血并发症（例如需要住院的出血）的发生率在阿司匹林组更高，显示出波立维令人满意的安全性。波立维临床相关的胃肠道出血危险性低于阿司匹林。而且由于排除标准的原因，波立维安全性优势的差异很可能被低估。 1. CAPRIE Steering Committee. A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). Lancet 1996;348:1329-1339. 2. Noble S, Goa KL. Ticlopidine: a review of its pharmacology, clinical efficacy and tolerability in the prevention of cerebral ischaemia and stroke. Drugs Aging 1996;8:214-232. 3. Prescribing information for clopidogrel bisulfate, US Food and Drug Administration, Nov 1997, page 12. * Data from the CAPRIE trial show that clopidogrel: reduced the rate of MI, stroke and vascular death in patients with a recent MI, recent stroke, or established PAD1 offered amplified benefits in patients with additional risk factors (diabetes, hypercholesterolemia)1 had a safety profile comparable to that of ASA1 reduced the rate of vascular events in low- and high-risk patients than ASA1–5 reduced MI, stroke, vascular death and hospitalizations event rate/year.5 References CAPRIE Steering Committee. Lancet 1996; 348: 1329–1339. Jarvis B, et al. Drugs 2000; 60: 347–377. Ringleb PA, et al. Eur Heart J 1999; 20: 666. Cannon C. J Am Coll Cardiol 2002; 39(abstr suppl): 290A. Bhatt DL, et al. J Am Coll Cardiol 2002; 39: 9–14. * Data from the CAPRIE trial show that clopidogrel: reduced the rate of MI, stroke and vascular death in patients with a recent MI, recent stroke, or established PAD1 offered amplified benefits in patients with additional risk factors (diabetes, hypercholesterolemia)1 had a safety profile comparable to that of ASA1 reduced the rate of vascular events in low- and high-risk patients than ASA1–5 reduced MI, stroke, vascular deat