Talk:Indus eff clopidogrel vs dipyridamol

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Effectiveness of clopidogrel and dipyridamole for secondary prevention of stroke

I try to find the effect of clopidogrel and dipyridamole according to the studies Match and ESPS2 which deal with secondary prevention of stroke(attachment ).

Mawentze


Media:prosit.doc

RE: Effect of clopidogrel and dipyridamole which secondary prevention of stroke conce

Thank you for your work here. I totally agree with your opinion regarding the MATCH trial.

I have been checking the medical effectiveness of clopidogrel, the combination of dipyridamole+ASA each vs. ASA in the most important studies for secondary stroke prevention.

  • Dipyridamole+ASA vs ASA
    • ESPRIT: risk reduction 0.76
    • ESPS: risk reduction 0.76
  • Clopidogrel vs ASA
    • CAPRIE: risk reduction 0.93


Not considered:

  • CHARISMA (clopidogrel versus placebo in vascular disease and high risk factors) – 3 years; 15,200 patients; because of comparison against placebo
  • MATCH (clopidogrel plus aspirin versus clopidogrel in high-risk patients with stroke and TIA) – 18 months; 7601 patients; because of bleeding and very high daily dosages
  • PROFESS (MR dipyridamole/aspirin versus clopidogrel plus aspirin in recurrent stroke) – 15,500 patients; planned completion in 2008. Obviously not available yet ;-)

I have concerns with clopidogrel regarding bleeding, which we do not consider in our model. We should keep this on our agenda. Because in a health-economic assessment the rather small effectiveness of this drug could easily be foiled by the cost for treating bleeding complications...


Wendelin Schramm