[CHC2012]血栓性病变与静脉桥血管病变的治疗——华盛顿大学医学中心Larry S. Dean教授专访
International Circulation: What potential do you see for China with the other anti-platelet drugs?
Dr. Dean: Overtime, as competition comes to the marketplace, these drugs will become less expensive. We have two others in the United States that are FDA approved: prasugrel and ticagrelor. They are metabolized differently, so they have a better overall impact on patient populations with variability in drug metabolism. That will eventually filter to China. Again there are no generics available yet and I think there will be some additional work in this area. Quite frankly, I do not believe that there is some silver bullet that works on platelets but does not cause bleeding. They will try to produce something that will have less long term side effects, primarily bleeding, but you cannot fool Mother Nature. If these drugs have an effect on bleeding, you are going to have bleeding complications.
《国际循环》:您如何看其他抗血小板药物在中国的潜力?
Dean教授:不久后,随着市场的竞争逐渐激烈,抗血小板药物的价格会下降。美国除氯吡格雷外,还有两个获得FDA批准的抗血小板药物,即普拉格雷和替格瑞洛。两者除对患者的总体效果都比氯吡格雷更好外,代谢也有所不同。普拉格雷和替格瑞洛最终会来到中国。现在还没有这两个药物的仿制药,我认为在抗血小板药物领域还会有其他发展。坦白来讲,我不认为会有一种治疗在抑制血小板聚集的同时不引起出血。研发人员会尽力生产出不良反应(主要是出血)更少的药物,但我们不能自欺欺人。如果药物对出血有影响,就一定会有出血并发症。