Platelet-Active Drugs: The Relationships Among Dose, Effectiveness, and Side Effects. part 41
Eptifibatide received approval from the FDA for use in
Table 8 —GPIIb/IIIa Antagonists in PCI
| Trial | Patients, No. | Compound | Placebo, % | GPIIb/IIIa Antagonist, % | RRR, % |
| EPIC | 2,099 | Abciximab | 10.3 | 6.9 | 30.0 |
| EPILOG | 2,792 | Abciximab | 9.1 | 3.8t | 58.2 |
| CAPTURE | 1,265 | Abciximab | 9.0 | 4.8 | 46.7 |
| EPISTENT | 1,603 | Abciximab | 10.2 | 4.8J | 52.9 |
| IMPACT-II | 4,010 | Eptifibatide | 8.4 | 6.9 | 17.9 |
| RESTORE | 2,139 | Tirofiban | 6.4 | 5.0 | 21.9 |
| ESPRIT | 1,023 | Eptifibatide | 9.2 | 5.5 | 40.0 |
| TARGET | 2,398 | Tirofiban | 7.2 | ||
| 2,411 | Abciximab | 5.7 | 21.8 | ||
| CADILLAC§ | |||||
| PTCA | 1,046 | Abciximab | 3.3 | 1.9 | 42.4 |
| Stent | 1,036 | Abciximab | 3.2 | 3.5 | -9.4 |
Rates of death or myocardial infarction at 30 days are shown. RRR = RR reduction; EPILOG = Evaluation in PTCA to Improve Long-term Outcome With Abciximab GPIIb/IIIa Blockade; CAPTURE = c7E3 Antiplatelet Therapy in Unstable Refractory Angina; EPISTENT = Evaluation of Platelet IIb/IIIa Inhibitor for Stenting Trial; TARGET = Tirofiban (Aggrastat) and ReoPro Give Similar Efficacy Outcomes Trial; CADILLAC = Controlled Abciximab (ReoPro) and Device Investigation to Lower Late Angioplasty Complications. tAbciximab plus low-dose heparin. jAbciximab plus stenting vs placebo plus stenting.
Death and reinfarction were recorded separately, not as a composite.
PCI in 1998 based on data from the IMPACT-II and PURSUIT trials, and the dosing was modified based on the efficacy demonstrated in the ESPRIT trial. The c7E3 Antiplatelet Therapy in Unstable Refractory Angina (CAPTURE) trial demonstrated the efficacy of treatment with abciximab for 18 to 24 h prior to PCI in patients with unstable angina who were refractory to conventional antithrombotic and antianginal therapy. The Evaluation in PTCA to Improve Long-Term Outcome With Abciximab GP IIb/IIIa Blockade (EPILOG) trial demonstrated the efficacy of abciximab therapy in a broad population of patients undergoing PCI, not just in high-risk patients, as in the EPIC and CAPTURE trials. The Evaluation of Platelet IIb/IIIa Inhibitor for Stenting (EPISTENT) trial demonstrated that abciximab therapy decreased the frequency of ischemic complications of PCI associated with stent insertion during the first 30 days, and that there also were fewer ischemic complications during this time period in patients who were treated with PCI and abcix-imab alone without stent insertion compared to those treated with stenting alone. Furthermore, the 1-year mortality rate difference was statistically significant between stenting alone (2.4%) and stenting plus abciximab therapy (1%), and this mortality rate difference was sustained for longer periods of time.
