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Message: Vorapaxar and anti-platelet therapy

G1945V posted about the anti-platelet therapy Vorapaxar over on Stockhouse and wondered "if there is a real market for a MACE reducing drug due to lack of interest for RVX by BP."

Targeted and robust anti-platelet therapies have their place in cardiovascular medicine. However, bleeding concerns are common with these therapies. If you want to read up on Vorapaxar, here's a good article:

Vorapaxar: The Current Role and Future Directions of a Novel Protease-Activated Receptor Antagonist for Risk Reduction in Atherosclerotic Disease

There are many anti-platelet therapies out there. Vorapaxar appears to be a new class in this category. Bleeding concerns appear to be a significant concern. In the article cited above, it does discuss how diabetic patients may benefit from Vorapaxar more than non-diabetic patients and how the increased risk of atherosclerotic disease in diabetic patients may justify the risk of bleeding with Vorapaxar use. An ongoing clinical trial is assessing the efficacy of Vorapaxar in diabetics.

Thrombosis has two primary components: coagulation cascade and platelet activation. Apabetalone has been shown to have beneficial effects on thrombosis by modulating the complement and fibrin clotting pathways. But keep in mind that apabetalone also beneficially affects many other pathways of importance for reducing cardiovascular risk. The keys to apabetalone's success are safety and efficacy. A safe, first-in-class, orally-available drug that can achieve robust relative risk reduction in 3-point MACE will be a potential blockbuster, especially since no other BET inhibitors or epigenetic drugs are currently in trial for cardiovascular or kidney disease other than apabetalone.

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