The FINANCIAL — On August 30, the OASIS study group will present initial results of the CURRENT-OASIS 7 clinical trial at the European Society of Cardiology congress in Barcelona.
Sanofi-aventis (EURONEXT: SAN, and NYSE: SNY) and Bristol-Myers Squibb (NYSE: BMY), co-commercialization and co-development partners for Plavix (clopidogrel), were sponsors of the study.
"CURRENT-OASIS 7 is the largest clinical trial (25,087 patients) to evaluate different dosing regimens of Plavix (clopidogrel) plus aspirin in a broad range of acute coronary syndrome (ACS) patients (UA/NSTEMI/STEMI). The study was designed to assess the efficacy and safety of an intensified clopidogrel regimen (600mg loading dose day1/150mg days 2-7/75 mg days 8-30) versus the approved Plavix dosage (300mg loading dose day1/75mg days 2-30) for patients managed with an early invasive strategy with an intent for percutaneous coronary intervention (PCI)," Sanofi-aventis informed.
The primary end-point (cardiovascular death, heart attack, or stroke at thirty days) for the entire study population (including subpopulations of patients that underwent PCI (70%) or not (30%) examining the difference between the high-dose and standard-dose Plavix regimens did not reach statistical significance (4.2% vs. 4.4%, HR 0.95, p=0.37).
For clinically relevant subgroups that were pre-specified for preliminary analyses such as the PCI subgroup (70% of the trial population, 17,232 patients) potentially medically relevant differences in patient outcomes were observed. In this subgroup, analysis showed an improvement in outcome for patients taking the higher dose regimen (600 mg loading / 150 mg for days 2-7/75 mg days 8-30) over the standard dose regimen (300 mg loading/75 mg for days 2-30), as shown by the reduction of the same composite end-point of cardiovascular death, myocardial infarction and stroke by 15% (4.5% vs 3.9%, p=0.037). In addition, analysis showed an important 42% relative risk reduction in definite stent thrombosis (1.2% vs 0.7%, p=0.001) with the higher-dose
regimen of clopidogrel over the standard loading dose.
“An artery opening procedure with stent placement exposes a patient to an increased risk of stent occlusion and subsequent heart attack,” said Doctor Jean-Pierre Lehner, Chief Medical Officer, sanofi-aventis. “CURRENT-OASIS 7 provides important new information about a high-dose regimen of Plavix in ACS patients planned for PCI. We are pleased to contribute to furthering the understanding of patient care during the acute phase of coronary intervention.”
The primary end-point was assessed by the stringent bleeding definition of OASIS and while a significant increase in the primary safety end-point of major bleeding with the high-dose compared to the standard-dose Plavix regimen was observed in the overall trial population (2.5% vs 2.0%, HR 1.25, p=0.01) and the PCI population (1.6% vs 1.1%, HR 1.44, p=0.006), there was no statistically significant difference in intracranial bleeding or fatal hemorrhage in the overall population and the PCI population.
Sanofi-aventis and Bristol-Myers Squibb believe that the CURRENT-OASIS 7 data add to the broad clinical experience with Plavix, which has been used in over 90 million patients during the 11 years it has been on the market.
Discussion about this post