Meta-Analysis Evaluates Medicure's Aggrastat for PCI Patients

February 23, 2016—Medicure Inc. announced the presentation of a study, “Comparison of High-Dose Bolus Tirofiban With Other Anticoagulation Strategies for Percutaneous Coronary Intervention: A Network Meta-Analysis of Randomized Controlled Trials,” by Primary Investigator Michael J. Lipinski, MD, at CRT 2016, the Cardiovascular Research Technologies conference in Washington, DC. The study is available online in Journal of the American College of Cardiology: Cardiovascular Interventions (2016;9:S28–S28).

As summarized by the company, the investigators pooled data from 41 randomized clinical trials to perform a network meta-analysis to directly and indirectly compare different glycoprotein IIb/IIIa inhibitor strategies for percutaneous coronary intervention with a focus on the impact of high-dose bolus tirofiban (Aggrastat, Medicure).

A total of 38,645 patients were included in the analysis; 2,654 patients were randomized to high-dose bolus tirofiban; 6,752 to abciximab; 1,669 to eptifibatide; 16,500 to heparin; and 11,070 to bivalirudin. Results of the analysis found that high-dose bolus tirofiban had a significant reduction in all-cause mortality when compared with both heparin and eptifibatide (P < .05). There was no significant difference among the glycoprotein IIb/IIIa inhibitor therapies for other outcomes, including myocardial infarction, major adverse cardiac events, and major bleeding, reported Medicure.

The company advised that this meta-analysis does not imply comparable efficacy, safety, or product interchangeability. Additionally, some of the patient populations were outside of the approved patient populations for tirofiban.

Tirofiban is indicated to reduce the rate of thrombotic cardiovascular events (combined endpoint of death, myocardial infarction, or refractory ischemia/repeat cardiac procedure) in patients with non–ST-elevation acute coronary syndrome.