Lamifiban. Point of view

Lamifiban is an intravenously administered, selective, reversible, nonpeptide glycoprotein IIb/IIIa receptor antagonist which inhibits platelet aggregation and thrombus formation by preventing the binding of fibrinogen to platelets. In trials in patients with non-Q wave myocardial infarction (Ml) or unstable angina pectoris (PARAGON A and the Canadian Lamifiban Study), the incidence of clinical events at 30 days in patients receiving lamifiban (1 to 5 μg/min) was not significantly different from that in patients receiving aspirin plus heparin or aspirin alone. In PARAGON A, the incidence of clinical events at 6 months was significantly lower after lamifiban (with or without heparin) and aspirin therapy than after standard heparin and aspirin therapy. A large phase III trial (PARAGON B) is under way comparing lamifiban plus aspirin and heparin with standard aspirin and heparin therapy in patients with non-Q wave Ml or unstable angina pectoris. In clinical trials, the most common adverse events associated with lamifiban were bleeding complications which were increased by the concomitant administration of heparin.