Comparing trials of glycoprotein IIb/IIIa receptor antagonists

Large, well-designed clinical trials are the basis for determining the effectiveness and safety of pharmacological agents. Clinical trials may appear similar while differing in important aspects. Differences in patient population, end-point definition and trial management make it difficult to draw cross-trial conclusions regarding relative safety and efficacy of different agents. Newly released antiplatelet drugs that antagonize the glycoprotein (GP) IIb/IIIa receptor have been examined in important clinical trials of patients with acute coronary syndromes. The PURSUIT trial of eptifibatide and the PRISM-PLUS trial of tirofiban are presented as examples of trials with important differences in design, and the potential impact of trial design on trial outcome is discussed. In addition, we compare and contrast the results of trials of GP IIb/IIIa inhibitors in percutaneous coronary interventions and address how differences in these trials may have affected their outcomes.