Heartburn drugs' interaction with anti-clotting drug may raise risk of heart attack
FRANKLIN LAKES, N.J. Four popular drugs used to treat heartburn may raise the risk of heart attack in patients taking a cardiovascular drug, according to a recent study presented at the annual scientific meeting of the Society for Cardiovascular Angiography and Interventions.
Researchers at pharmacy benefit manager Medco Health Solutions and the Indiana University School of Medicine found that four proton-pump inhibitors – Wyeth’s Protonix (pantoprazole), AstraZeneca’s Nexium (esomeprazole) and Prilosec (omeprazole), and Takeda Pharmaceuticals’ Prevacid (lansoprazole) – could reduce the effectiveness of Sanofi-Aventis’s and Bristol-Myers Squibb’s anti-platelet drug Plavix (clopidogrel), thus raising the risk of heart attack and stroke. Other proton-pump inhibitors were not included in the study due to the low number of patients taking them.
“There’s a growing body of evidence that PPIs decrease the effectiveness of clopidogrel and put cardiovascular patients at a much higher risk, a huge concern given the large number of patients affected,” Medco chief medical officer and study researcher Robert Epstein stated. “While this study confirms prior research in this area, it brings us a step further in our understanding by showing that this is a problem associated with each of the four most popular PPIs.”
The study, part of the Clopidogrel Outcomes Study, investigated pharmacy claims data of 16,690 patients taking Plavix following a stent procedure and tracked the subjects for a 12-month period from 2005 to 2006, comparing 6,828 patients taking Plavix and a proton-pump inhibitor to 9,862 taking Plavix alone.
“Our study, along with a 2007 FDA review and other researchers’ work, provides strong evidence that PPIs do not independently raise cardiovascular risks for stent patients, and further strengthens the observation that this interaction exists between PPIs and clopidogrel and impairs the effectiveness of the anti-platelet drug,” Epstein said.