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Scientific article
Editorial
English

Antiplatelet drugs and platelet reactivity: is it time to halt clinical research on tailored strategies?

Contributors

Reny, Jean-Luc; Fontana, Pierre

Published in

Expert opinion on pharmacotherapy, vol. 16, no. 4, p. 449-452

Publication date

2015

Abstract

Personalized medicine of antiplatelet drugs in cardiovascular patients has led to a significant enthusiasm. Indeed, numerous longitudinal studies showed an association between high platelet reactivity and the recurrence of ischemic events. The first small randomized trials of P2Y12 blockers tailored to each patient's platelet reactivity yielded encouraging reductions of coronary stent thrombosis in high-risk populations. The discovery of genetic variants contributing to the pharmacodynamic effect of clopidogrel has then paved the way toward a personalized antiplatelet therapy based on reliable and stable genetic tests. This enthusiasm was soon tempered by large interventional trials demonstrating that a platelet function testing-based strategy did not improve clinical outcome and that genetic variants discovered up to now only explained a small part of the pharmacodynamic effect of clopidogrel, thus limiting its clinical use. Looking back to the most recent trials, their target populations and the type of clinical setting, it seems that the one-size-fits all policy regarding antiplatelet drugs may be well acceptable for low-risk patients. On the contrary, integration of the clinical setting as well as other risk factors may help to identify subgroups of patients who could derive a benefit from a truly personalized management of antiplatelet therapy.

UNIGE affiliation entities

UNIGE research groups

Citation (ISO format)

RENY, Jean-Luc, FONTANA, Pierre. Antiplatelet drugs and platelet reactivity: is it time to halt clinical research on tailored strategies? In: Expert opinion on pharmacotherapy, 2015, vol. 16, n° 4, p. 449–452. doi: 10.1517/14656566.2015.993608

Main files (1)

Article (Published version)

Identifiers

Journal ISSN

1465-6566
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Technical informations

Creation

16/02/2015 16:20:00

First validation

16/02/2015 16:20:00

Update

13/10/2025 21:46:12

Status update

03/02/2025 11:32:08

Last indexation

28/09/2026 12:17:10
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