Double the Dose of Clopidogrel or Switch to Prasugrel to Antagonize Proton Pump Inhibitor Interaction. (DOSAPI)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01175200
Recruitment Status : Completed
First Posted : August 4, 2010
Last Update Posted : July 4, 2012
Groupe Hospitalier Pitie-Salpetriere
Medco Health Solutions, Inc.
Information provided by (Responsible Party):
Ascopharm Groupe Novasco

Brief Summary:
This study will establish the optimal therapeutic strategy for patients with a coronary artery disease (CAD) and chronically treated with clopidogrel 75 mg/day requiring co-administration of an anti-platelet treatment with P2Y12 antagonist and a PPI for treatment/prevention of GI ulceration.

Condition or disease Intervention/treatment Phase
Anti Platelet Effects Drug: Clopidogrel Drug: Prasugrel Drug: Lansoprazole Drug: Placebo Not Applicable

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 82 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Double the Dose of Clopidogrel or Switch to Prasugrel to Antagonize Proton Pump Inhibitor Interaction. A Prospective, Mono-center, Placebo- and Active Treatment-controlled, Randomized, Cross Over Study.
Study Start Date : September 2010
Actual Primary Completion Date : July 2012
Actual Study Completion Date : July 2012

Resource links provided by the National Library of Medicine

U.S. FDA Resources

Arm Intervention/treatment
Active Comparator: Prasugrel Drug: Prasugrel
antiplatelet agent
Active Comparator: Clopidogrel Drug: Clopidogrel
antiplatelet agent
Active Comparator: Lansoprazole
proton pump inhibitor
Drug: Lansoprazole
proton pum inhibitor
Other Names:
  • Lanzor
  • Ogast
Placebo Comparator: Placebo Drug: Placebo
placebo comparator similar to lansoprazole

Primary Outcome Measures :
  1. Change in antiplatelet effect of clopidogrel [ Time Frame: 14 days ]
    change in antiplatetelet effect of clopidogrel as compared to prasugrel when associated to lansoprazole (or placebo) in patients with stable angina

Secondary Outcome Measures :
  1. high on-treatment platelet reactivity Clopidogrel pharmacokinetics responses [ Time Frame: 14 days ]
    compare persistant antiplatelet hyper reactivity in patients with stable angina and treated with clopidogrel or prasugrel associated with lansoprazole (or placebo)

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Ages Eligible for Study:   18 Years to 75 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria :

  • patient with stable Coronary Artery Disease (< 3 months) treated with clopidogrel (75mg/d)
  • Between 18 and 75 years of age
  • Body Mass Index between 18 and 30 kg/m2 and body weight not less than 60 kg
  • No major bleeding according to ISTH definition
  • Subjects who signed an informed consent document
  • Subjects who signed a separate pharmacogenomic informed consent document
  • Subjects registered to the French national welfare system

Exclusion Criteria:

  • Personal or family history of coagulation or bleeding disorders
  • Use of known inhibitors or inducers of CYP2C19 and CYP3A including grape fruit juice intake
  • Known hypersensitivity to lansoprazole, its excipients, or substituted benzimidazoles,
  • Known hypersensitivity to clopidogrel / prasugrel
  • Anti-platelet treatment other than clopidogrel + aspirin within 7 days before inclusion
  • Any formal indication to maintain PPI treatment
  • PPI within 15 days before inclusion in the study
  • Active pathology with 10 days before inclusion
  • Prior history of stent thrombosis
  • Prior history of Stroke
  • Employee of the investigator or study center, with direct involvement in the proposed study or other studies under the direction of that investigator or study center, as well as family members of the employees or the investigator.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01175200

Pitié Salpétrière Hospital
Paris, France, 75013
Sponsors and Collaborators
Ascopharm Groupe Novasco
Groupe Hospitalier Pitie-Salpetriere
Medco Health Solutions, Inc.

Responsible Party: Ascopharm Groupe Novasco Identifier: NCT01175200     History of Changes
Other Study ID Numbers: DOSAPI
First Posted: August 4, 2010    Key Record Dates
Last Update Posted: July 4, 2012
Last Verified: July 2012

Additional relevant MeSH terms:
Prasugrel Hydrochloride
Proton Pump Inhibitors
Platelet Aggregation Inhibitors
Purinergic P2Y Receptor Antagonists
Purinergic P2 Receptor Antagonists
Purinergic Antagonists
Purinergic Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Physiological Effects of Drugs
Fibrinolytic Agents
Fibrin Modulating Agents
Cytochrome P-450 CYP2C19 Inhibitors
Cytochrome P-450 Enzyme Inhibitors
Enzyme Inhibitors
Anti-Ulcer Agents
Gastrointestinal Agents