Cangrelor for treatment of coronary thrombosis.
OBJECTIVE
To review and assess available literature on the chemistry, pharmacology, pharmacodynamics, pharmacokinetics, clinical studies, adverse events, drug interactions, special populations, and dosing and administration for cangrelor, a product in late stage Phase II clinical trials.


METHODS
A literature search of MEDLINE (1966-March 2006), International Pharmaceutical Abstracts (1970-February 2006), and Cochrane database (first quarter 2006) was conducted using key terms of cangrelor, AR-C69931MX, and P2Y12 receptor antagonist. Bibliographies of relevant articles were reviewed for additional references. The Medicines Company Web site was reviewed, and a company representative was contacted.


METHODS
Available English-language literature, including abstracts, preclinical studies, clinical trials, and review articles, was reviewed.


RESULTS
Cangrelor is a P2Y12 antagonist under development for treatment of acute coronary syndrome. Cangrelor has been studied as an intravenous infusion in doses of 2 or 4 microg/kg/min. It inhibits platelet aggregation with rapid onset and offset and does not require metabolism for therapeutic activity. Published Phase II trials have demonstrated safety and inhibition of platelet aggregation.


CONCLUSIONS
Cangrelor is a promising investigational medication for inhibition of platelet aggregation in acute arterial coronary events. Phase II trials have shown safety and a greater inhibition of platelet aggregation over clopidogrel. Phase III trials will provide more definitive information on clinical efficacy and safety. Until then, the role of cangrelor is uncertain.
Fugate
Susan E
SE
College of Pharmacy, University of Oklahoma, Oklahoma City, OK 73190-5040, USA. susan-fugate@ouhsc.edu
Cudd
Laura A
LA
D000249:Adenosine Monophosphate / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D000818:Animals; D002986:Clinical Trials as Topic; D003328:Coronary Thrombosis / Q000188:drug therapy*; D004347:Drug Interactions; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D058919:Purinergic P2 Receptor Antagonists
D010975:Platelet Aggregation Inhibitors; D058919:Purinergic P2 Receptor Antagonists; D000249:Adenosine Monophosphate; C117446:cangrelor