Suppressive therapy manages clopidogrel hypersensitivity

Clopidogrel hypersensitivity, which affects 6% of patients, can be successfully treated using short-course corticosteroids and antihistamines without interrupting drug therapy, reported researchers at Jefferson Medical College in Philadelphia.

The study population consisted of 25 consecutive patients showing clopidogrel hypersensitivity after percutaneous coronary intervention. They had developed clopidogrel hypersensitivity 6±2 days after drug initiation. The patients were treated with corticosteroids (5 patients), antihistamines (5 patients), or corticosteroids and antihistamines (15 patients). Patients treated with corticosteroids received a tapering course for a mean of 10±8 days.

Suppressive therapy resulted in sustained symptom resolution in 22 of 25 patients (88%). Patients who were successfully desensitized continued clopidogrel therapy for 417±369 days; 16 patients with drug-eluting stents continued for 529±376 days. No deaths, myocardial infarctions, or stent thrombosis occurred during the extended follow-up period.

"Clopidogrel hypersensitivity can be successfully treated using short-course corticosteroids and antihistamines without interrupting therapy," the authors concluded. "This technique enables long-term continuation of clopidogrel and confers a low risk of adverse cardiac events.”