The biggest study of a new drug ever conducted - involving more than 19,000 people in 16 countries - found that an experimental blood thinner works a little better than the humble aspirin in warding off heart attacks and strokes.
Although aspirin is best known as a pain reliever, its most important use these days is preventing blood clots that lead to heart attacks and strokes. As a result, drug companies have been trying to build a better aspirin.
On Wednesday, a Canadian team released the results of one of these medicines, known generically as clopidogrel, at a meeting of the American Heart Association.
When tested on people who already had clogged arteries, clopidogrel reduced the risk of new heart attacks and strokes by one-third, compared with one-quarter for aspirin.
“This is very exciting,” said Michael Gent, a researcher at Hamilton Civic Hospitals Research Center in Hamilton, Ontario. “Here is a drug that is more effective than aspirin, which is the gold standard, and it is probably safer.”
Clopidogrel is being developed jointly by the drug companies Sanofi and Bristol-Myers Squibb, who paid for the study. Gent said it will be submitted to the Food and Drug Administration for approval by the start of 1997.
The price of the drug has not been announced, but it certainly will be more than aspirin, which costs pennies. The difference could influence whether doctors prescribe it for their heart and stroke patients, most of whom are already taking several other expensive medicines.
Whether it will be widely used “will depend on the cost. People have to take these drugs for many years,” said Dr. Rose Marie Robertson of Vanderbilt University.
The study involved 19,185 patients in North America, Europe and Australia who had suffered heart attacks, strokes or pain from clogged arteries in their legs.
They were randomly assigned to take either aspirin or clopidogrel for periods ranging from one to three years. The researchers recorded 5.8 new heart attacks, strokes or deaths from cardiovascular disease annually for every 100 patients taking aspirin, compared with 5.3 for those getting clopidogrel.