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Suppressive Therapy Manages Clopidogrel Hypersensitivity

Corticosteroids and antihistamines resolve symptoms while allowing for continued drug use

MONDAY, March 21 (HealthDay News) -- Clopidogrel hypersensitivity, which affects up to 6 percent of patients, may be successfully managed using corticosteroids and antihistamines, without interrupting drug therapy, according to a study published in the March 15 issue of The American Journal of Cardiology.

Kimberly L. Campbell, M.D., of Jefferson Medical College in Philadelphia, and colleagues examined whether suppressive therapy could allow for resolution of hypersensitivity to clopidogrel, without requiring a washout period off the drug. Twenty-five patients who developed clopidogrel hypersensitivity after percutaneous coronary intervention were treated with a short course of corticosteroids (five patients), antihistamines (five patients), or both (15 patients). Patients who were treated with steroids received a tapering course for a mean of 10±8 days. Outcome measures included treatment success, duration of clopidogrel therapy, and adverse cardiac events during late follow-up.

The researchers found that suppressive therapy was successful, resulting in sustained symptom resolution in 22 of 25 patients (88 percent). Overall, patients who were successfully desensitized continued clopidogrel therapy for 417±369 days and the 16 patients with drug-eluting stents continued for 529±376 days. Extended follow-up revealed no deaths, myocardial infarctions, or stent thrombosis.

"Clopidogrel hypersensitivity can be successfully treated using short-course corticosteroids and antihistamines without interrupting drug therapy. This technique enables long-term continuation of clopidogrel and confers a low risk of adverse cardiac events," the authors write.

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