Why the study?
Because CYP3A4 metabolizes both vonoprazan and prasugrel, there is concern that a CYP3A4-mediated drug-drug interaction might attenuate the antiplatelet effect of prasugrel during DAPT after PCI.
Does vonoprazan attenuate the antiplatelet effect of prasugrel compared to proton pump inhibitors in patients with coronary artery disease?
Does vonoprazan attenuate the antiplatelet effect of prasugrel compared to proton pump inhibitors in patients with coronary artery disease?
Vonoprazan does not significantly attenuate the antiplatelet effect of prasugrel compared to conventional proton pump inhibitors in patients with coronary artery disease undergoing PCI.
Supports comparable prasugrel effect with vonoprazan versus PPIs; leaves open confirmation in randomized outcome trials.
Background:Vonoprazan is a potassium-competitive acid blocker increasingly used in Japan to prevent upper gastrointestinal bleeding in patients undergoing dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI). Cytochrome P450 (CYP) 3A4 is involved in the primary metabolism of both vonoprazan and prasugrel. This raises concern about the possibility of a CYP3A4-mediated drug-drug interaction between vonoprazan and prasugrel that may lead to attenuation of prasugrel’s antiplatelet effect.
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Koga et al. (2020) studied this question.
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