A randomized comparison of platelet reactivity in patients after treatment with various commercial clopidogrel preparations: The CLO-CLO trial Étude randomisée comparant la réactivité plaquettaire des patients traités par diverses préparations commerciales de clopidogrel. Étude CLO-CLO

Background. — The salt linked to the clopidogrel molecule in generic preparations is suspected to affect its clinical efficacy. There is a lack of information about inhibition of platelet reactivity by generic preparations. Aims. — To compare the effect of original clopidogrel (clopidogrel bisulphate [Plavix®]), generic clopidogrel preparations (clopidogrel hydrochloride [Clopidogrel-Mepha®]; clopidogrel besylate [Clopidogrel Sandoz®]) and prasugrel (Efient®) on platelet reactivity in patients with coronary artery disease. Methods. — Patients with coronary artery disease treated with stents received, in a random sequence, original clopidogrel bisulphate, clopidogrel hydrochloride and clopidogrel besylate. Platelet function was assessed with the Multiplate analyser after an initial loading dose (600 mg) and at day 10 after each treatment period. Prasugrel was given for another 10 days. An adenosine diphosphate (ADP) test value < 46 antiaggregation units (U) was defined as therapeutic platelet inhibition. Results. — Sixty patients (mean age 69 ± 10 years; 50 men) were randomized. Original clopidogrel bisulphate, clopidogrel hydrochloride and clopidogrel besylate provided similar inhibition