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Antiplatelet agents and anticoagulants for hypertension.

BACKGROUND: Elevated systemic blood pressure results in high intravascular pressure but the main complications, coronary heart disease (CHD) … evated blood pressure. Ticlopidine, clopidogrel and newer antiplatelet agents such as prasugrel and ticagrelor have not been sufficiently evaluated in patients with high blood pressure. Newer antithrombotic oral drugs such as dabigatran, rivaroxaban, apixaban and endosaban are yet to be tested in patients with high blood pressure.Further trials of antithromb …

Clinical Study for Safety Evaluation of GXN Tablets Combined with Aspirin in Long-Term Treatment of Coronary Heart Disease.

BACKGROUND: GXN tablets are composed of Danshen and Chuanxiong, with the functions of activating blood circulation, removing blood stasis, i … ents with stable CHD who received dual antiplatelet therapy (DAPT) with aspirin plus clopidogrel or ticagrelor for more than 12 months and then switched to the treatment with aspirin alone for 1 month. This study includes a total of 3,595 subjects in 63 hospitals. The experimental group took aspirin orally (100 mg, 1 time/day) + GXN tablets (0-6 months: 4 ta …

Breakthroughs in Medicinal Chemistry: New Targets and Mechanisms, New Drugs, New Hopes-5.

Breakthroughs in Medicinal Chemistry: New Targets and Mechanisms, New Drugs, New Hopes is a series of Editorials which is published on a biannual basis by the Editorial Board of the Medicinal Chemistry section of the journal Molecules [...].

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… Repurposing Ticagrelor: When an Antiplatelet Drug Could Emerge as a Potent Antibacterial Agent Highlighted by Jean Jacques Vanden Eynde Ticagrelor ( A ; CAS 274693-27-5) is a trisubstituted triazolo[4,5- d ]pyrimidine acting as a blood-thinning agent by reversibly inhibiting the interactions between … Interestingly, ticagrelor and one metabolite exhibited a bactericidal activity superior to that of vancomycin against selected antibiotic-resistant Gram-positive bacteria. Figure 1 Chemical structure of ticagrelor. 4. …

Antibodies to watch in 2022.

In this 13th annual installment of the annual 'Antibodies to Watch' article series, we discuss key events in commercial antibody therapeutics development that occurred in 2021 and forecast events that might occur in 2022. Regulatory review of antibody therapeutics that target the SARS-CoV-2 coronavirus proceeded at an unprecedented pace in 2021, resulting in both emergency use authorizations and full approvals for sotrovimab, regdanvimab, REGEN-COV2, as well as others, in numerous countries. As of November 1, a total of 11 antibody therapeutics had been granted first approvals in either the Un

Clinical and cost-effectiveness of clopidogrel resistance genotype testing after ischaemic stroke or transient ischaemic attack: a systematic review and economic model.

BACKGROUND: Stroke or transient ischaemic attack patients are at increased risk of secondary vascular events. Antiplatelet medications, most … controlled trials compared clopidogrel with alternative treatment in people with genetic variants. Ticagrelor was associated with a lower risk of secondary vascular events than clopidogrel (summary hazard ratio 0.76, 95% confidence interval 0.65 to 0.90; two studies). Objective 3: Twenty-five studies compared outcomes in people with and without genetic vari …

Dual Antiplatelet Therapy and Cancer; Balancing between Ischemic and Bleeding Risk: A Narrative Review.

Cardiovascular (CV) events in patients with cancer can be caused by concomitant CV risk factors, cancer itself, and anticancer therapy. Since malignancy can dysregulate the hemostatic system, predisposing cancer patients to both thrombosis and hemorrhage, the administration of dual antiplatelet therapy (DAPT) to patients with cancer who suffer from acute coronary syndrome (ACS) or undergo percutaneous coronary intervention (PCI) is a clinical challenge to cardiologists. Apart from PCI and ACS, other structural interventions, such as TAVR, PFO-ASD closure, and LAA occlusion, and non-cardiac dis

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… On the contrary, newer P2Y12 antagonists, such as ticagrelor and prasugrel, should be avoided due to their high bleeding risk and the lack of data on this patient subset. … Prasugrel should not be used concomitantly with an OAC, while ticagrelor may be a good alternative to clopidogrel for specific cases of cancer patients [ 74 ]. …

Acquired platelet disorders.

Platelets are essential to primary hemostasis, and defects in their number or function can lead to clinically significant bleeding or thrombosis. Acquired platelet disorders are far more common than the inherited forms and arise in a wide range of settings, including drug exposure, autoimmune, systemic, and critical illnesses. This review examines current understanding of the mechanisms driving acquired platelet dysfunction and outlines the diagnostic and therapeutic approaches that are shaping contemporary standards of care. Drug-related and immune-mediated platelet defects remain the most re

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… Unlike Thienopyridines, ticagrelor is a direct and active inhibitor of P2Y 12 that can neutralize transfused platelets for up to 24 h after ingestion. … If ticagrelor was taken beyond 24 h, platelet transfusion could provide partial recovery ( 114 ). Bentracimab (MEDI2452) is an investigational recombinant monoclonal antibody that reverses the effect of ticagrelor and its active metabolite. …

Escherichia coli in the production of biopharmaceuticals.

Escherichia coli has shouldered a massive workload with the discovery of recombinant DNA technology. A new era began in the biopharmaceutical industry with the production of insulin, the first recombinant protein, in E. coli and its use in treating diabetes. After insulin, many biopharmaceuticals produced from E. coli have been approved by the US Food and Drug Administration and the European Medicines Agency to treat various human diseases. Although E. coli has some disadvantages, such as lack of post-translational modifications and toxicity, it is an important host with advantages such as bei

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… Antibody‐based ticagrelor reversal agent in healthy volunteers. N Engl J Med. 2019;380:1825–1833. 108. Kathman SJ, Wheeler JJ, Bhatt DL, Arnold SE, Lee JS. … Bentracimab for ticagrelor reversal in patients undergoing urgent surgery. NEJM Evidence. 2022;1:EVIDoa2100047. 110. Damato BE, Dukes J, Goodall H, Carvajal RD. Tebentafusp: T cell redirection for the treatment of metastatic uveal melanoma. Cancers. 2019;11:971. 111. …

Outcomes of Individuals With and Without Heart Failure Presenting With Acute Coronary Syndrome.

Major adverse cardiac event (MACE) and bleeding risks following percutaneous coronary intervention (PCI) for acute coronary syndromes (ACS) are not well defined in individuals with heart failure (HF). We followed 1,145 individuals in the Pharmacogenomic Resource to improve Medication Effectiveness Genotype Guided Antiplatelet Therapy cohort for MACE and bleeding events following PCI for ACS. We constructed Cox proportional hazards models to compare MACE and bleeding in those with versus without HF, adjusting for sociodemographics, comorbidities, and medications. We also determined predictors o

Impact of Anemia on the Risk of Bleeding Following Percutaneous Coronary Interventions in Patients ≥75 Years of Age.

Bleeding risk stratification is an unresolved issue in older adults. Anemia may reflect subclinical blood losses that can be exacerbated after percutaneous coronary intervention . We sought to prospectively determine the contribution of anemia to the risk of bleeding in 448 consecutive patients aged 75 or more years, treated by percutaneous coronary interventions without concomitant indication for oral anticoagulation. We evaluated the effect of WHO-defined anemia on the incidence of 1-year nonaccess site-related major bleeding. The prevalence of anemia was 39%, and 13.1% of anemic and 5.2% of

Antiplatelet versus anticoagulation treatment for people with heart failure in sinus rhythm.

BACKGROUND: People with chronic heart failure have an increased risk of thrombotic complications, including stroke and thromboembolism, whic … r at least one month. We compared oral antiplatelets (aspirin, ticlopidine, clopidogrel, prasugrel, ticagrelor, dipyridamole) versus OAC (coumarins, warfarin, non-vitamin K oral anticoagulants). DATA COLLECTION AND ANALYSIS: Three review authors independently assessed trials for inclusion and assessed the benefits and harms of antiplatelet therapy versus OA …

Antibodies to watch in 2026.

The Antibodies to Watch article series provides annual updates on commercial late-stage clinical development, regulatory review, and marketing approvals of antibody therapeutics. Since the first article was published in 2010, the late-stage pipeline has grown from 26 antibody therapeutics to over 200, while during the same time numerous molecules in late-stage studies either transitioned to regulatory review and were approved or were terminated. In this installment of the series, we recap first marketing approvals granted to 19 antibody therapeutics in 2025, discuss 26 molecules currently in r

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… INN Target; Format Indication(s) under review Country of review Bentracimab Ticagrelor; Human IgG1λ Fab Reversal of the antiplatelet effects of ticagrelor US Apitegromab Myostatin; Human IgG4λ Spinal muscular atrophy EU, US Denecimig Factor IXa, Factor X; Human IgG4κ; Bispecific Hemophilia A EU, US Gefurulimab … INN | Target; Format | Indication(s) under review | Country of review Bentracimab | Ticagrelor; Human IgG1λ Fab | Reversal of the antiplatelet effects of ticagrelor | US Apitegromab | Myostatin; Human IgG4λ | Spinal muscular atrophy | EU, US Denecimig | Factor IXa, Factor X; Human IgG4κ; Bispecific | …

EHA Guidelines on Management of Antithrombotic Treatments in Thrombocytopenic Patients With Cancer.

In cancer patients, thrombocytopenia can result from bone marrow infiltration or from anticancer medications and represents an important limitation for the use of antithrombotic treatments, including anticoagulant, antiplatelet, and fibrinolytic agents. These drugs are often required for prevention or treatment of cancer-associated thrombosis or for cardioembolic prevention in atrial fibrillation in an increasingly older cancer population. Data indicate that cancer remains an independent risk factor for thrombosis even in case of thrombocytopenia, since mild-to-moderate thrombocytopenia does n

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… Clinically relevant DDIs should be always considered, especially for clopidogrel, ticagrelor, warfarin, and dabigatran (see Suppl. Table S1 ). Level 1, grade D e. … Grade 2–4 TP: We recommend against DAPT with ticagrelor or prasugrel. Level 5, grade D d. Grade 2: We recommend using DAPT with clopidogrel. Level 3b, grade C e. …

Coronary Artery Disease and Cancer: Treatment and Prognosis Regarding Gender Differences.

Cardiovascular disease and cancer remain the leading causes of hospitalization and mortality in high-income countries. Survival after myocardial infarction has improved but there is still a difference in clinical outcome, mortality, and developing heart failure to the disadvantage of women with myocardial infarction. Most major cardiology trials and registries have excluded patients with cancer. As a result, there is only very limited information on the effects of coronary artery disease in cancer patients. In particular, the outcomes in women with cancer and coronary artery disease and its ma

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… According to the “Twilight Study,” another option is to continue using the guanosine 5’-diphosphate inhibitor (GDP) ticagrelor and discontinue ASA instead [ 86 ]. However, cancer patients were not specifically mentioned in the study. … Ticagrelor with or without Aspirin in High-Risk Patients after PCI. N. Engl. J. Med. 2019;381:2032–2042. doi: 10.1056/NEJMoa1908419. 87. Lee S.W., Lam S.C., Tam F.C., Chan K.K., Shea C.P., Kong S.L., Wong A.Y., Yung A., Zhang L.W., Tse H.-F., et al. A. …

Antiplatelet agents for chronic kidney disease.

BACKGROUND: Antiplatelet agents are widely used to prevent cardiovascular events. The risks and benefits of antiplatelet agents may be diffe … data were available for direct head-to-head comparisons of antiplatelet drugs, including prasugrel, ticagrelor, different doses of clopidogrel, abciximab, defibrotide, sarpogrelate and beraprost. AUTHORS' CONCLUSIONS: Antiplatelet agents probably reduced myocardial infarction and increased major bleeding, but do not appear to reduce all-cause and cardiovasc …

Responsible, Safe, and Effective Use of Antithrombotics and Anticoagulants in Patients Undergoing Interventional Techniques: American Society of Interventional Pain Physicians (ASIPP) Guidelines.

BACKGROUND: Interventional pain management involves diagnosis and treatment of chronic pain. This specialty utilizes minimally invasive proc … vidence that discontinuation of antiplatelet therapy (clopidogrel [Plavix®], ticlopidine [Ticlid®], Ticagrelor [Brilinta®] and prasugrel [Effient®]) avoids complications of significant bleeding and epidural hematomas.13. There is very limited evidence supporting the continuation or discontinuation of most NSAIDs, excluding aspirin, for 1 to 2 days and some 4 …

Antiplatelet versus anticoagulation treatment for patients with heart failure in sinus rhythm.

BACKGROUND: Morbidity in patients with chronic heart failure is high, and this predisposes them to thrombotic complications, including strok … We compared orally administered antiplatelet agents (aspirin, ticlopidine, clopidogrel, prasugrel, ticagrelor, dipyridamole) versus anticoagulant agents (coumarins, warfarin, non-vitamin K oral anticoagulants). DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trials for inclusion and assessed the risks and benefits of antithrombotic …

Multiple myeloma presenting as acute tubulointerstitial nephritis.

BACKGROUND: Acute tubulointerstitial nephritis (ATIN) is a very rare paraneoplastic manifestation in patients with multiple myeloma (MM). It is an uncommon pattern of renal disease in such patients. CASE PRESENTATION: We report a case of an 82-year-old male who was admitted with acute kidney injury. Renal biopsy showed typical findings of light chain-associated ATIN with scattered inflammatory cells in the interstitium and associated active tubulitis. No other common manifestations of MM were present at the time of presentation, including hypercalcemia, hyperuricemia, proteinuria, bone pain o

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… His medications included ibuprofen, oxycodone, gabapentin, atorvastatin, losartan, carvedilol, furosemide, ticagrelor, apixaban, pioglitazone, insulin glargine, sitagliptin, tamsulosin and escitalopram. He had no known allergies. …

Antibodies to watch in 2025.

The commercial development of antibody therapeutics is a global enterprise involving thousands of biopharmaceutical firms and supporting service organizations. To date, their combined efforts have resulted in over 200 marketed antibody therapeutics and a pipeline of nearly 1,400 investigational product candidates that are undergoing evaluation in clinical studies as treatments for a wide variety of diseases. Here, we discuss key events in antibody therapeutics development that occurred during 2024 and forecast key events related to the late-stage clinical pipeline that may occur in 2025. In pa

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… ), thereby reversing the antiplatelet effects of ticagrelor and its active metabolite. … Ticagrelor is an oral P2Y 12 platelet inhibitor with a product label that includes a black box warning regarding bleeding risk. The FDA and EMA have granted bentracimab Breakthrough Therapy and PRIME designations, respectively. …

Emerging disease-modifying therapies for sickle cell disease.

Sickle cell disease afflicts millions of people worldwide and approximately 100,000 Americans. Complications are myriad and arise as a result of complex pathological pathways 'downstream' to a point mutation in DNA, and include red blood cell membrane damage, inflammation, chronic hemolytic anemia with episodic vaso-occlusion, ischemia and pain, and ultimately risk of cumulative organ damage with reduced lifespan of affected individuals. The National Heart, Lung, and Blood Institute's 2014 evidence-based guideline for sickle cell disease management states that additional research is needed bef

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… largest multinational phase III trials in pediatric SCD and found that prasugrel did not reduce the rate of vaso-occlusive episodes in pediatric and adolescent patients up to 17 years of age when compared to placebo. 100 In addition, a phase II study (HESTIA2, NCT02482298 ) assessing the impact of ticagrelor … Kanter J Abboud MR Kaya B Ticagrelor does not impact patient-reported pain in young adults with sickle cell disease: a multicentre, randomised phase IIb study . Br J Haematol . 2019 ; 184 ( 2 ): 269 – 278 . 30443999 10.1111/bjh.15646 PMC6587797 102. …