GPs keeping patients on clopidgrel longer than a year

07 Mar 08

An analysis of data from 61 general practices found a third of patients were prescribed the combination for longer than the recommended year.

As many as 40% of patients on the combination for more than a year had had a previous ischaemic stoke or transient ischaemic attack, putting them at increased risk of bleeding, the Scottish study found. The results are published online in Pharmacoepidemiology and Drug Safety.

Study leader Dr Colin Simpson, research fellow at the University of Aberdeen, said NICE guidelines for treatment with combined clopidogrel/low dose aspirin recommended it just last at least one, but no longer than 9-12 months.

‘GPs may wish to review patients treated with the combination therapy, as the economic benefit of continued clopidogrel use after 12 months is likely to be lessened for a drug that costs approximately 30 times more than aspirin therapy,’ he added.

But Dr Terry McCormack, a GP in Whitby, East Yorkshire and chair of the Primary Care Cardiovascular Society, said there was a good reason why some patients were being left on treatment longer than recommended.

‘We’re not sure how long people should be on them – some GPs may simply being cautious. There are lots of studies going on at the moment and the recommendation may well change in the future – NICE has delayed its deliberations until they have more evidence.’

The study comes a month after a US study found patients had almost double the risk of dying or having an acute myocardial infarction within the first 90 days of abruptly ceasing clopidogrel treatment.