The experimental anti-clotting drug cangrelor solidly outperformed commonly used clopidogrel in a large global trial of patients who underwent coronary stent procedures, according to data from the phase III CHAMPION PHOENIX study presented today at the American College of Cardiology's 62nd Annual Scientific Session.
Cangrelor and clopidogrel interfere with the P2Y12 receptor, a platelet-surface protein that helps regulate blood clotting. Currently approved drugs in this class are effective in cutting down ischemic events-blood-flow reductions that can cause heart attack and stroke- in patients who need percutaneous coronary intervention (PCI), but they have important clinical limitations: they're slow to take effect, remain active for days and come only in pill form. For patients on recent anti-platelet therapy who need timely coronary intervention, that profile poses risk of surgical bleeding if the drug is still active or risk from postponing surgery until the drug's effect wears off. Additionally, oral drugs present problems for anyone who urgently needs stenting and is in no condition to swallow or absorb a clot-preventing pill. Cangrelor is administered intravenously, takes effect rapidly and wears off an hour after the infusion ends.
CHAMPION PHOENIX, a randomized double-blind trial, pitted the novel IV drug cangrelor against the oral clopidogrel standard of care in approximately 11,000 patients at 153 centers around the world. An "all-comers" clinical trial, it included a broad cross-section of patients with every type of acute coronary syndrome, angina and other conditions for which people undergo PCI, as long as they had no recent exposure to a P2Y12 inhibitor and could swallow a pill. Other exclusion criteria included recent use of anti-clotting agents called GP IIb/IIIa inhibitors or fibrinolytics and specific indications of high risk of bleeding.