FDA approves vorapaxar, a new oral antiplatelet

This is the first antiplatelet agent with a specific PAD indication. We now have multiple such agents to consider in our vascular patients. Time will tell which should be used in the management of the asymptomatic patient or those who have had either surgical or endovascular interventions. Currently, the other new agent, ticagrelor, is under investigation in the EUCLID study (Astra Zeneca). Hopefully there will ultimately be comparative studies of all antiplatelet agents. However, in my current practice I will prescribe clopidogrel for patients who do not have a contraindication and who can afford it. Otherwise aspirin will suffice in most patients. I reserve dual-antiplatelet agents for patients who demonstrate high risk or who have a history of graft or endovascular procedure thrombosis.

Dr. Russell Samson is the medical editor of Vascular Specialist.