Subcutaneous selatogrel inhibits platelet aggregation in AMI patients

Platelet aggression is inhibited in patients with acute myocardial infarction (AMI) following subcutaneous administration of selatogrel, which induces a profound, rapid, and dose-related antiplatelet response, according to a study.

The investigators randomized 47 AMI patients to a single subcutaneous dose of selatogrel 8 (n=24) or 16 mg (n=23). Response to treatment (P2Y₁₂ reaction units <100; measured by VerifyNow) at 30 min postdose was the primary endpoint. They assessed safety up to 48 h after injection.

Following injection with selatogrel, AMI patients received either ticagrelor (n=43) or clopidogrel (n=1). The proportion of patients who responded to treatment 30 min postdose was 91 percent (one-sided 97.5 percent confidence interval [CI], 80–100 percent; p=0.142) with 8 mg and 96 percent (97.5 percent CI, 87–100 percent; p=0.009) with 16 mg.

Response rates were independent of age, sex, or AMI presentation type. A similar response rate was seen at 15 min (8 mg: 75 percent, 97.5 percent CI, 58–100 percent; 16 mg: 91 percent, 97.5 percent CI, 80–100 percent). Such response was sustained at 60 min postdose (8 mg: 75 percent, 97.5 percent CI, 58–100 percent; 16 mg: 96 percent, 97.5 percent CI, 87–100 percent).

Median P2Y₁₂ reaction units at 15 min was 51 (range, 4–208) and 9 (range, 2–175) for 16 mg. Selatogrel was well tolerated and did not lead to major bleeding complications.

“Oral P2Y₁₂ receptor antagonists exhibit delayed onset of platelet inhibition in patients with AMI,” the investigators said. “Selatogrel is a potent, highly selective, and reversible P2Y₁₂ receptor antagonist with a rapid onset and short duration of action.”