Efficacy and safety of clopidogrel versus prasugrel and ticagrelor for coronary artery disease treatment in patients with CYP2C19 LoF alleles: a systemic review and meta‐analysis

Review of 12 studies (5,829 patients with CYP2C19 loss‐of‐function alleles) found those given ticagrelor or prasugrel had a lower risk of MACE (RR=0.52), CV death (0.41), all cause death (0.44) and stent thrombosis (0.55) than those who received clopidogrel (all p<0.05).

SPS commentary:

Major and minor bleeding risk was not significantly different between groups.  Authors conclude that CYP2C19 reduced‐metabolisers can expect better clinical outcome on using prasugrel or ticagrelor rather than clopidogrel.

British Journal of Clinical Pharmacology