Episode 90: Zoster pain and the pain of using PPIs with clopidogrel

Submitted by admin on Fri, 2010-06-18 16:52

In episode 90, Mike and James solicit the mainly brilliant, but always delightful help of Mike Kolber and Tina Korownyk. We talk about what to do for the chronic pain that can be associated with Herpes zoster and we have a quick look at the old and new data surrounding the area of PPIs and platelet inhibitors.

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Comments

I am not sure if this is a

Submitted by DavidSandhu (not verified) on Wed, 2010-06-23 23:13.

I am not sure if this is a flawed way of looking at this, but one way to see the Clopidogrel and PPI interaction is like this. Clopidogrel is medication with established RCT data for secondary prevention in patients with an ACS and/or ACS with Stent (DES or non-DES). If a drug was stop or prevent a patient from recieving therapy (much like as if the patient never took the medication in the first place), then would the increase in mortality or reoccurence of ACS not be roughly equal to that of the original established RCT evidence for Clopidogrel?

As we have learned from many of your guys' podcast, rarely do you see a medication have a ARR near 10%. Looking back at the CURE study (or CURE-PCI) we know that Clopidogrel does not reduce events to that degree.

So without much investigation, can one not just conclude that these populations cohort studies can not show an interaction?

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