New research by the University of East Anglia (UEA) shows no risk in combining two commonly-prescribed treatments for patients at risk of heart attacks and strokes. Published this month in the journal Alimentary Pharmacology & Therapeutics, the study is the largest investigation yet into concerns of an adverse interaction between Proton Pump Inhibitors (PPIs) and the antiplatelet drug clopidogrel. The researchers analysed data from 23 large randomised clinical trials involving more than 90,000 patients worldwide. It concluded that co-prescribing the two drugs caused no adverse
effect.
"Recent studies have suggested that patients receiving clopidogrel will not get the full effect of the treatment if they are also taking PPIs," said lead author Dr Yoon Loke, of UEA's School of Medicine. "The aim of our study was to determine the actual effect of the treatment combination on cardiovascular outcomes and mortality.
"Our findings showed no evidence of any effect on overall mortality and no associated risk with the co-prescribing of these agents. It is therefore premature to impose a blanket policy of withdrawal or avoidance of PPI use in patients taking clopidogrel. Clinicians should instead re-focus on a patient's susceptibility to gastric bleeding and not lose sight of the fact that some patients with high gastrointestinal risk may genuinely benefit from PPI therapy."
