Trial reportClinical cardiology2013
Platelet inhibitory effect of clopidogrel in patients treated with omeprazole, pantoprazole, and famotidine: a prospective, randomized, crossover study.
Trial report in Clinical cardiology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 5 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Efficacy and Safety of Clopidogrel With and Without a Proton Pump Inhibitor: A Systematic Review and Meta-Analysis.Basic & clinical pharmacology & toxicology · 2025Pooled it
- Understanding Drug Interactions in Antiplatelet Therapy for Atherosclerotic Vascular Disease: A Systematic Review.CNS neuroscience & therapeutics · 2025Pooled it
- Guideline
- Clopidogrel-Proton Pump Inhibitor Drug-Drug Interaction and Risk of Adverse Clinical Outcomes Among PCI-Treated ACS Patients: A Meta-analysis.Journal of managed care & specialty pharmacy · 2016Pooled it
- Pooled it
- Associations Between PFA-Measured Aspirin Resistance, Platelet Count, Renal Function, and Angiotensin Receptor Blockers.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis · 2018Trial
- Trial
- Potential drug-drug interactions in patients with cardiovascular diseases: findings from a prospective observational study.Journal of pharmaceutical policy and practice · 2021Article
- Different Clopidogrel Response Elicited by Lansoprazole or Esomeprazole in Patients Undergoing Neurointervention with Dual Antiplatelet Therapy.Clinical drug investigation · 2019Article
- Incompatible intravenous drug combinations and respective physician and nurse knowledge: a study in routine paediatric intensive care.European journal of hospital pharmacy : science and practice · 2019Article
- Pantoprazole-induced acute kidney injury: A case report.Experimental and therapeutic medicine · 2018Article
- Comparison of prophylactic effect of UGIB and effects on platelet function between PPIs and HTherapeutics and clinical risk management · 2017Article
- PA32540 for the secondary prevention of cardiovascular disease in patients at risk for aspirin-associated gastric ulcers.Expert review of cardiovascular therapy · 2014Review
- Hyperglycemia in patients referred for cardiac catheterization is associated with preexisting diabetes rather than a stress-related phenomenon: a prospective cross-sectional study.Clinical cardiology · 2014Article
- Clopidogrel and proton pump inhibitors.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2014Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundConcerns about an inhibitory effect of proton pump inhibitors (PPIs) on clopidogrel metabolism have been raised. Because the pharmacological effect of clopidogrel is dependent on genetically determined activity of the hepatic cytochrome P450 isoenzymes system, it is important to examine the interaction between different PPIs and high on-treatment platelet reactivity (HPR) after controlling for genetic variability. The aim of the study was to assess the effect of 2 PPIs and a histamine-2 (H2) receptor-blocker on platelet reactivity in a crossover trial where each patient was alternately treated with each drug. HYPOTHESIS: Omeprazole reduces HPR more than other PPI or H2 blockers.
methodsPatients treated with aspirin and clopidogrel for at least 1 month were assigned to 3 consecutive 1-month treatment periods during which they were treated with each of the 3 study medications twice daily: omeprazole 20 mg, famotidine 40 mg, and pantoprazole 20 mg. At the end of each treatment phase, platelet function was evaluated with the Verify Now system using 2 cutoff values (>208 P2Y12 reaction units [PRUs] and >230 PRUs) for the definition of HPR.
resultsPatients with HPR were older than those without HPR (62 ± 10 vs 55 ± 8 years, respectively, P = 0.03). HPR was more prevalent during omeprazole therapy compared to famotidine or pantoprazole (48%, 33%, and 31%, respectively, for the 208 PRU cutoff, P= 0.04; and 37%, 17%, and 23%, respectively, for the 230 PRU cutoff, P= 0.003).
conclusionsAfter eliminating the effects of interindividual variability in clopidogrel metabolism, omeprazole therapy was associated with substantially more HPR than famotidine or pantoprazole.
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