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Generic Clopidogrel Noninferior to Plavix in Seniors With ACS

Clopidogrel noninferior for patients older than 65 years after acute coronary syndrome hospitalization

FRIDAY, March 16, 2018 (HealthDay News) — For patients aged older than 65 years with an acute coronary syndrome (ACS) hospitalization, generic clopidogrel is noninferior to Plavix for the composite of death and recurrent hospitalization for ACS, according to a study published online March 13 in Circulation: Cardiovascular Quality and Outcomes.

Dennis T. Ko, M.D., from the Sunnybrook Health Sciences Centre in Toronto, and colleagues conducted a population-based observational study to determine whether generic clopidogrel was noninferior to Plavix among patients aged >65 years hospitalized with ACS from 2009 to 2014. A composite of death and recurrent ACS at one year was assessed as the primary outcome. The effect of clopidogrel on the hazard of clinical outcomes was estimated within the propensity-weighted cohort, which included 24,530 patients with ACS; 12,643 and 11,887 patients were prescribed Plavix and generic clopidogrel, respectively, at hospital discharge.

The researchers found that the primary outcome was experienced by 17.6 percent of patients prescribed Plavix and 17.9 percent prescribed clopidogrel at one year (hazard ratio, 1.02; 95 percent confidence interval, 0.96 to 1.08; P = 0.005 for noninferiority). The rates of death, all-cause readmission, ACS, stroke or transient ischemic attack, or bleeding did not differ significantly between the groups.

“Our findings support generic clopidogrel in ACS, which could lead to substantial health care cost savings,” the authors write.

One author disclosed financial ties to the pharmaceutical and medical technology industries.

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