Landmark trial by Indian doctor suggests shift in treatment for diabetic heart patients

New Orleans (US), Nov 11 (PTI) A landmark trial by an Indian doctor, involving the largest head-to-head comparison of two major anti-platelet drugs in diabetic patients undergoing a procedure to open blocked or narrowed heart arteries, has indicated a potential shift in the clinical management of such patients.

Both drugs have become generic internationally.

The results of the trial, known as "TUXEDO-2”, were presented at the American Heart Association (AHA) scientific sessions on Monday. The results suggest a potential shift in the treatment of high-risk diabetic patients following the placement of drug-eluting stents.

The trial, led by eminent Indian cardiologist Dr Upendra Kaul, Chairman of Cardiology at Delhi’s Batra Hospital, compared two anti-platelet drugs, Ticagrelor and Prasugrel, head-to-head in 1,800 diabetic patients across 66 Indian centres who had undergone multi-vessel angioplasty.

Diabetic patients are inherently at higher risk of adverse outcomes, including stent clotting.

Dr Kaul said that the trial results address the existing gap in consensus regarding the use of anti-platelet drugs for diabetic patients undergoing percutaneous coronary intervention (PCI).

The trial showed that the anti-platelet medication Prasugrel, originally developed by a Japanese company, had better outcomes compared to Ticagrelor, a similar drug manufactured by a British-Swedish multinational.

He said that while international guidelines generally recommend more potent agents such as Ticagrelor or Prasugrel over another anti-platelet medication, Clopidogrel, in high-risk patients, the choice between Ticagrelor and Prasugrel has remained debatable, with previous trials offering conflicting evidence.

The European guidelines favour Prasugrel in this context, while the American guidelines have remained silent on Prasugrel and primarily recommend Ticagrelor, which has often been the preferred agent in the absence of a clear national consensus.

“The data from our trial will reduce the gap in the consensus on usage of anti-platelet drugs in the clinical management of diabetic patients who have undergone procedures to open the blocked or narrowed heart arteries," Dr Kaul said. PTI SKL GRS GRS