Drug Hikes Death Risk for Kidney Disease Patients

Clopidogrel increased overall and cardiovascular death risk in cohort from the CHARISMA trial

21 june 2009-- Patients with kidney disease (diabetic nephropathy) receiving clopidogrel to inhibit blood clotting are at increased risk for death, according to a study reported in the May 15 American Journal of Cardiology.

Arijit Dasgupta, M.D., of the University of Kentucky in Lexington, and colleagues analyzed data drawn from the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management, and Avoidance (CHARISMA) trial to assess the long-term outcomes of clopidogrel use in patients with chronic kidney disease. In the analysis, 15,603 CHARISMA trial patients were divided into three study groups: patients without diabetes; patients with diabetes but without nephropathy; and patients with both diabetes and nephropathy. The outcomes for subjects in each group receiving clopidogrel were compared to subjects receiving placebo.

The researchers discovered that patients with nephropathy who received clopidogrel were found to have increased cardiovascular and overall mortality compared to those on placebo (5.1 versus 3.1 percent and 7.3 versus 4.5 percent, respectively). For the patients without diabetes, or with diabetes but without nephropathy, there were no significant differences in overall or cardiovascular mortality for those on clopidogrel compared to placebo.

"In conclusion, this post hoc analysis suggested that clopidogrel may be harmful in patients with diabetic nephropathy. Additional studies are needed to investigate this possible interaction," the authors write.

The CHARISMA trial was supported by Sanofi Aventis and Bristol-Myers Squibb.

Abstract
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