J Pharmacoepidemiol Risk Manage.  2022 Mar;14(1):51-57. 10.56142/2022.14.1.51.

Comparison of Uric Acid Elevation between Aspirin-Ticagrelor and Aspirin-Prasugrel during Dual Antiplatelet Therapy: A Pilot Study

Affiliations
  • 1Department of Pharmaceutical Services, Samsung Medical Center, Seoul, Korea

Abstract


Objective
This study evaluated the safety of aspirin-prasugrel (AP) compared to aspirin-ticagrelor (AT) with regards to uric acid (UA) elevation among patients with acute coronary syndrome.
Methods
Retrospective analyses of patients who were prescribed aspirin-ticagrelor and aspirin-prasugrel between January 1st, 2017, and December 31st, 2019, at the Samsung Medical Center were conducted with a 6-month follow-up. The primary endpoint was the absolute increase (delta UA) and the change from baseline (%var UA) serum UA levels between the AT and AP groups. The secondary end point was the change in drugs or the addition of UA lowering agents due to elevations in serum UA levels.
Results
Among a total of 754 patients, 548 patients were in the AT group and 206 patients were in the AP group. The delta UA (mg/dL) was 0.73 in the AT group and 0.45 in the AP group (p = 0.746). The %var UA (%) was higher in the AT group at 17.54 compared to 11.10 in the AP group (p = 0.908), but this difference was not statistically significant. The number of cases where the drugs were changed or UA lowering agents were added was 36 (6.57%) in AT group and 7 (3.40%) in AP group, and this difference was not statistically significant (odds ratio, 1.999; 95% confidence interval, 0.875 to 4.566; p = 0.094).
Conclusion
There was no significant difference in serum uric acid levels between the AT and AP groups in this pilot study. Further research with a larger number of patients is needed.

Keyword

Drug-related side effect and adverse reactions; Uric acid; Dual anti-platelet therapy; Ticagrelor; Prasugrel hydrochloride
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