Prasugrel, which will be marketed in Europe as Efient“, will be the first major competitor to clopidogrel, which has a much broader range of indications and is one of the world’s best selling pharmaceuticals. Prasugrel is a more potent antiplatelet agent than clopidogrel and is not thought to be associated with so much variability as clopidogrel.
The increased antiplatelet potency of prasugrel would be expected to translate into a higher efficacy in preventing ischaemic events, but also a higher risk of bleeding.
This is exactly what was seen in the large-scale TRITON-TIMI 38 trial, on which the approval of prasugrel is based.
In the