Ticlopidine: A New Drug to Prevent Stroke

  • William K. Hass


Two papers describing stroke prevention trials in more than 4000 patients of the drug ticlopidine hydrochloride appeared in 1989.1,2 There was unequivocal evidence in one of a reduction of risk of the composite end point: stroke, myocardial infarction, and vascular death in patients after ischemic stroke. In the other, significant reduction of the risk of nonfatal stroke and death in patients with transient ischemic attacks (TIA), transient monocular blindness, or minor stroke was seen when ticlopidine was compared in a “horse race” to aspirin. Since ticlopidine, previously a little known drug, has proved effective in large and carefully structured clinical trials, 3 a close examination of its origin, pharmacological characteristics, and clinical safety is indicated.


Ischemic Stroke Stroke Prevention Nonfatal Stroke Vascular Death Aspirin Group 
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  1. 1.
    Gent M, Easton JD, Hachinski VC, et al. The Canadian American Ticlopidine Study (CATS) in thromboembolic stroke. Lancet. 1989; 1:1215 – 1220.PubMedCrossRefGoogle Scholar
  2. 2.
    Hass WK, Easton JD, Adams HP Jr, et al. A randomized trial comparing ticlopidine hydrochloride with aspirin for the prevention of stroke in high-risk patients. N Engl J Med. 1989;321:501–507.PubMedCrossRefGoogle Scholar
  3. 3.
    Goyan IE. The “trials” of a longterm clinical trial: the ticlopidine Aspirin Stroke Study and the Canadian-American Ticlopidine Study. Controlled Clinical Trials. 1989;10(suppl):236–244.CrossRefGoogle Scholar
  4. 4.
    Maffrand JP, Eloy F. Synthese de thienopyridines a l’etude de furopyridines d’interet therapeutique. Eur J Med Chem. 1974;9:483–486.Google Scholar
  5. 5.
    Bousser MG. Personal communication.Google Scholar
  6. 6.
    Thebault JJ, Blatrix CE, Blanchard JF, et al. Effects of ticlopidine, a new platelet aggregation inhibitor in man. Clin Pharmacol Ther. 1975;18:485–490.PubMedGoogle Scholar
  7. 7.
    Lecrubier C, Coeard J, Samama M, et al. Essai randomise d’un nouvel agent anti-aggregant: la ticlopidine. Therapie. 1977;32:189–194.PubMedGoogle Scholar
  8. 8.
    Maeda K, Usudo M, Kowaguchi S, et al. Effects of ticlopidine on thrombotic obstruction of A-V shunts and on dialysis of artificial kidneys. Artif Organs. 1980;4:30–33.PubMedCrossRefGoogle Scholar
  9. 9.
    Maffrand JP, Defreyn G, Bernot A, et al. Reviewed pharmacology of ticlopidine. Angiologie. 1988;5 (suppl):5–13.Google Scholar
  10. 10.
    Panak E, Maffrand JP, Picard-Fraire T, et al. Ticlopidine: a promise for the prevention and treatment of thrombosis and its complications. Haemostasis. 1983;13(suppl 1):1–54.PubMedGoogle Scholar
  11. 11.
    Lips JPM, Sixma JJ, Schiphorst ME. The effect of ticlopidine administration to humans on binding of adenosine diphosphate to blood platelets. Thromb Res. 1980;17:19–27.PubMedCrossRefGoogle Scholar
  12. 12.
    Ordinas A. Personal communication.Google Scholar
  13. 13.
    DeMinno G, Cerbone AM, Mattiali PL, et al. Functionally thrombasthenic state in normal patients following the administration of ticlopidine. J Clin Invest. 1985;75:328–338.CrossRefGoogle Scholar
  14. 14.
    Hass WK. Aspirin for the limping brain (editorial). Stroke. 1977;8:299–301.PubMedCrossRefGoogle Scholar
  15. 15.
    Fieschi C, Argentino C, Lenzi GL, et al. Clinical and instrumental evaluation of patients with ischemic stroke within the first six hours. J Neurol Sci. 1989; 91:311–322.PubMedCrossRefGoogle Scholar
  16. 16.
    Canadian Cooperative Study Group. A randomized trial of aspirin and sulfinpyrazone in threatened stroke. N Engl J Med. 1978;299:53–59.CrossRefGoogle Scholar
  17. 17.
    Bousser MG, Eschwege E, Haguenau M, et al. “AICLA” controlled trial of aspirin and dipyridamole in the secondary prevention of atherothrombotic cerebral ischemia. Stroke. 1983;14:5–14.PubMedCrossRefGoogle Scholar
  18. 18.
    Stroke Prevention in Atrial Fibrillation Study Group Investigators. Special Report: Preliminary report of the stroke prevention in atrial fibrillation study. N Engl J Med. 1990;322:863–868.Google Scholar
  19. 19.
    Antiplatelet Trialists Collaboration. Open communication, April 1990.Google Scholar
  20. 20.
    Dyken ML. Transient ischemic attacks and aspirin, stroke and death; negative studies and type II error. Editorial. Stroke. 1983;14:2–4.PubMedCrossRefGoogle Scholar
  21. 21.
    Ono H, Mizukami M, Kitamura K, et al. Subarachnoid hemorrhage. Agents Actions. 1984;15(suppl): 259–272.Google Scholar
  22. 22.
    Tohgi H. The effect of ticlopidine on TIA compared with aspirin: a double-blind twelve-month follow-up study. Agents Actions. 1984;15(suppl):279–282.Google Scholar
  23. 23.
    Rieger JS, Picho JLT. Effect of ticlopidine on the prevention of relapses of cerebrovascular ischemic disease. Med Clin (Barcelona). 1984;82:62–64.Google Scholar
  24. 24.
    Hart RG. Comparison of ticlopidine and aspirin for the prevention of stroke (letter). N Engl J Med. 1990;322:404–405.CrossRefGoogle Scholar
  25. 25.
    Hass WK, Molony BA, Anderson SA, Kamm A. Comparison of ticlopidine and aspirin for the prevention of stroke (correspondence). N. Engl J Med. 1990;322:404–405.CrossRefGoogle Scholar
  26. 26.
    Warlow C. Ticlopidine a new antithrombotic drug: but is it better than aspirin for longterm use? (editorial). J Neurol Neurosurg Psychiat. 1990;53: 185–187.PubMedCrossRefGoogle Scholar
  27. 27.
    Uchiyama S, Sone R, Nagayama T, et al. Combination therapy with low-dose aspirin and ticlopidine in cerebral ischaemia. Stroke. 1989;20:1643–1647.PubMedCrossRefGoogle Scholar

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© Springer Science+Business Media New York 1991

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  • William K. Hass

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