Oral glycoprotein IIb/IIIa receptor inhibitors in patients with cardiovascular disease: why were the results so unfavourable

A dose-finding study of fondaparinux in patients with non–ST-segment elevation acute coronary syndromes

“…Similar nonsignificant differences were observed at 30-day follow-up (data not shown). Yet, it should be appreciated that small, statistically not significant differences in phase II studies may relate to unfavorable outcomes in larger phase III studies (26). Careful monitoring in subsequent studies with fondaparinux in ACS will be appropriate, particularly in view of the slightly higher mortality in patients receiving fondaparinux.…”

Platelet-Active Drugs: The Relationships Among Dose, Effectiveness, and Side Effects

“…The consistent finding of these large-scale trials involving Ͼ 40,000 patients is that therapy with oral GPIIb/IIIa antagonists (ie, xemilofiban, orbofiban, sibrafiban, and lotrafiban) is not more effective than aspirin therapy or, when combined with aspirin, is not superior to placebo and may in fact increase mortality. 291 One is that the poor oral bioavailability of these compounds and the target of approximately 50% inhibition of platelet aggregation resulted in poor antiplatelet activity in many patients. 291 One is that the poor oral bioavailability of these compounds and the target of approximately 50% inhibition of platelet aggregation resulted in poor antiplatelet activity in many patients.…”

Coagulation, inflammation and myocardial dysfunction in unstable coronary artery disease and the influence of glycoprotein IIb/IIIa inhibition and low molecular weight heparin

“…In fact, the therapies have been associated with an increased incidence of bleedings and a modest increase in mortality (115), illustrating the potential risk with this type of treatment.…”