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Current Vascular Pharmacology

Editor-in-Chief

ISSN (Print): 1570-1611
ISSN (Online): 1875-6212

Review Article

Treatment of Clopidogrel Hypersensitivity: The Jefferson Approach

Author(s): Alec Vishnevsky, Michael P. Savage and David L. Fischman*

Volume 17, Issue 2, 2019

Page: [123 - 126] Pages: 4

DOI: 10.2174/1570161116666180730100346

Price: $65

Abstract

Despite the advent of newer antiplatelet therapies, clopidogrel remains the mainstay of treatment for patients with cardiovascular disease, especially those who undergo coronary stent implantation. Hypersensitivity reactions to clopidogrel that develop soon after stenting present a significant clinical challenge. The widespread use of clopidogrel in the management of patients with coronary artery disease necessitates awareness of treatment options in the setting of an allergic reaction. It has been demonstrated that clopidogrel hypersensitivity can be successfully managed without interrupting clopidogrel therapy. We review available treatment options and highlight the treating-through approach developed at our institution.

Keywords: Clopidogrel, hypersensitivity, allergy, percutaneous coronary intervention, hypersensitivity treatment, ACS.

Graphical Abstract
[1]
Levine GN, Bates ER, Blankenship JC, et al. 2011 ACCF/AHA/SCAI Guideline for percutaneous coronary intervention. J Am Coll Cardiol 2011; 58(24): 44-122.
[2]
Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC Guideline for the management of patients with non-ST-Elevation acute coronary syndromes. J Am Coll Cardiol 2014; 64(24): 139-228.
[3]
Kernan WN, Ovbiagele B, Black HR, et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2014; 45(7): 2160-236.
[4]
Siu H, Kaliyadan A, Fischman DL, et al. Use of prasugrel in the setting of clopidogrel hypersensitivity: Case report and systematic review of the literature. Platelets 2016; 27: 824-7.
[5]
Campbell KL, Cohn JR, Fischman DL, et al. Management of clopidogrel hypersensitivity without drug interruption. Am J Cardiol 2011; 107: 812-6.
[6]
Lokhandwala J, Best PJM, Henry Y, et al. Allergic reactions to clopidogrel and cross-reactivity to other agents. Curr Allergy Asthma Rep 2011; 11: 52-7.
[7]
Lokhandwala JO, Best PJM, Butterfield JH, et al. Frequency of Allergic or hematologic adverse reactions to ticlopidine among patients with allergic or hematologic adverse reactions to clopidogrel. Circ Cardiovasc Interv 2009; 2: 348-51.
[8]
Cheema AN, Mohammad A, Hong T, et al. Characterization of clopidogrel hypersensitivity reactions and management with oral steroids without clopidogrel discontinuation. J Am Coll Cardiol 2011; 58: 1445-54.
[9]
Cohn JR, Savage MP. Hypersensitivity reactions to clopidogrel Up-to-date Online 2017: Available from: https://www.uptodate.com/contents/hypersensitivity-reactions-to-clopidogrel
[10]
Ellerbroek JC, Cleveland MG. Clopidogrel-associated acute generalized exanthematous pustulosis. Cutis 2011; 87: 181-5.
[11]
Fischer TC, Worm M, Groneberg DA. Clopidogrel-associated angioedema. Am J Med 2003; 114: 77-8.
[12]
Khambekar SK, Kovac J, Gershlick AH. Clopidogrel induced urticarial rash in a patient with left main stem percutaneous coronary intervention: Management issues. Heart 2004; 90: e14.
[13]
von Tiehl KF, Price MJ, Valencia R, et al. Clopidogrel desensitization after drug-eluting stent placement. J Am Coll Cardiol 2007; 50: 2039-43.
[14]
Harris JR, Coons JC. Ticagrelor use in a patient with a documented clopidogrel hypersensitivity. Ann Pharmacother 2014; 48: 1230-3.
[15]
Manchette AM, Drucker AG, Januzzi JL. Acute coronary syndrome antiplatelet alternatives in clopidogrel allergy. Pharmacotherapy 2014; 34: 152-6.
[16]
Peppard SR, Held-Godgluck BM, Beddingfield R. Use of prasugrel in a patient with clopidogrel hypersensitivity. Ann Pharmacother 2011; 45: 54.
[17]
van Werkum JW, Braber TL, Verheggen PWHM, et al. Prasugrel as alternative treatment strategy in a case with a hypersensitivity reaction to clopidogrel. Platelets 2011; 22: 77-8.

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