Last Updated: May 10, 2026

CLINICAL TRIALS PROFILE FOR PRASUGREL HYDROCHLORIDE


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505(b)(2) Clinical Trials for PRASUGREL HYDROCHLORIDE

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
New Dosage NCT02435563 ↗ Dose Adaptation to Offset the Interaction Between Ticagrelor and Ritonavir by Population-based PK Modeling Completed University Hospital, Geneva Phase 2 2014-08-01 Ticagrelor is a new generation antiplatelet agent with higher efficacy as compared to clopidogrel and prasugrel in treatment of patients with moderate and high ischemic risks. Ticagrelor is active as such and its hepatic metabolism by CYP3A generates also an active metabolite. Because of the remarkable progress in HIV therapies the number of older age patients is on the rise, requiring adequate cardiovascular treatment. Since frontline HIV therapies include ritonavir, a strong inhibitor of CYP3A enzyme, ticagrelor is contraindicated in these patients because of the expected interaction and bleeding risk. A lower efficacy of clopidogrel and prasugrel, which are both pro-drugs, in the presence of ritonavir has been already demonstrated. Therefore, administration of a lower dose of ticagrelor may be a good alternative in HIV patients in order to lessen the impact of this pharmacokinetic interaction. The aim of this study is to adjust the dose of ticagrelor in case of co-treatment with ritonavir to achieve the same pharmacokinetic profile as administered alone using a physiologically-based pharmacokinetic (PBPK) model. As the first step, a pharmacokinetic (PK) model for ticagrelor and its active metabolite will be created based on available in vitro and in vivo parameters in healthy volunteers. An open-label, 2 sessions cross over study will be conducted with 20 healthy male volunteers at Clinical Research Center (CRC) of Geneva University Hospitals (HUG). During the first session of the clinical trial, a single dose 180 mg ticagrelor will be administered to the volunteers and obtained pharmacokinetic data will be fitted into the model for optimization. Thereafter a simulated trial by the Simcyp® simulator in presence of a single dose 100 mg ritonavir will allow evaluating the impact of CYP3A inhibition on the concentration-time profile of ticagrelor and its active metabolite. The necessary dose of ticagrelor to minimize the magnitude of this interaction will be calculated. This new dose will be co-administered with ritonavir in the same volunteers during the second session of the clinical trial. The purpose is to obtain the same PK profile with single dose of 180 mg ticagrelor administered alone and with an adapted dose of ticagrelor co-administered with a single dose 100 mg ritonavir. Moreover, the pharmacodynamic effect of ticagrelor will be measured in both sessions of the clinical trial using two specific platelet function tests: the VAsodilator-Stimulated Phosphoprotein assay (VASP) and VerifyNow® P2Y12. With the same PK profile, the same pharmacodynamic activity is expected. The modulation of activity of CYP3A and P-gp by ritonavir will be also monitored using micro dose midazolam and fexofenadine as probe substrates. The purpose of this study is to use the Simcyp® Simulator mechanistic PBPK modeling to broaden the application field of ticagrelor, especially in HIV patients. Since PK models are often created after clinical observations, the prospective aspect of this study is of particular value as the model will be first created and then applied to an unknown clinical scenario.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for PRASUGREL HYDROCHLORIDE

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00059215 ↗ A Trial of CS-747 (Prasugrel) Compared With Clopidogrel in Patients Undergoing Percutaneous Coronary Intervention (PCI) Completed Eli Lilly and Company Phase 2 2003-04-01 The purpose of this study is to evaluate the effects of a drug known as CS-747 (also known as prasugrel) on subjects having a procedure called a percutaneous coronary intervention (also referred to as PCI) in which a doctor will attempt to open a blocked vessel (or vessels) in the heart using a catheter (a long thin tube) that has a small balloon on the end. In many cases, patients who have this procedure receive a stent, a small wire spring that helps keep the vessel open.
NCT00097591 ↗ A Comparison of Prasugrel (CS-747) and Clopidogrel in Acute Coronary Syndrome Subjects Who Are to Undergo Percutaneous Coronary Intervention Completed Daiichi Sankyo Inc. Phase 3 2004-11-01 The sponsors of this investigational drug are developing prasugrel (also known as CS-747) as a possible treatment for patients with acute coronary syndrome (heart attack or chest pain) who need, or are expected to need, a percutaneous coronary intervention (PCI; also called a balloon angioplasty). Prasugrel was compared with Clopidogrel to determine which drug is better at reducing deaths, future heart attacks, or stroke.
NCT00097591 ↗ A Comparison of Prasugrel (CS-747) and Clopidogrel in Acute Coronary Syndrome Subjects Who Are to Undergo Percutaneous Coronary Intervention Completed Daiichi Sankyo, Inc. Phase 3 2004-11-01 The sponsors of this investigational drug are developing prasugrel (also known as CS-747) as a possible treatment for patients with acute coronary syndrome (heart attack or chest pain) who need, or are expected to need, a percutaneous coronary intervention (PCI; also called a balloon angioplasty). Prasugrel was compared with Clopidogrel to determine which drug is better at reducing deaths, future heart attacks, or stroke.
NCT00097591 ↗ A Comparison of Prasugrel (CS-747) and Clopidogrel in Acute Coronary Syndrome Subjects Who Are to Undergo Percutaneous Coronary Intervention Completed Eli Lilly and Company Phase 3 2004-11-01 The sponsors of this investigational drug are developing prasugrel (also known as CS-747) as a possible treatment for patients with acute coronary syndrome (heart attack or chest pain) who need, or are expected to need, a percutaneous coronary intervention (PCI; also called a balloon angioplasty). Prasugrel was compared with Clopidogrel to determine which drug is better at reducing deaths, future heart attacks, or stroke.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for PRASUGREL HYDROCHLORIDE

Condition Name

Condition Name for PRASUGREL HYDROCHLORIDE
Intervention Trials
Coronary Artery Disease 70
Acute Coronary Syndrome 48
Myocardial Infarction 17
Platelet Reactivity 7
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Condition MeSH

Condition MeSH for PRASUGREL HYDROCHLORIDE
Intervention Trials
Coronary Artery Disease 82
Acute Coronary Syndrome 68
Myocardial Ischemia 66
Coronary Disease 63
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Clinical Trial Locations for PRASUGREL HYDROCHLORIDE

Trials by Country

Trials by Country for PRASUGREL HYDROCHLORIDE
Location Trials
United States 476
United Kingdom 41
Italy 40
Germany 32
Korea, Republic of 29
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Trials by US State

Trials by US State for PRASUGREL HYDROCHLORIDE
Location Trials
Florida 41
Texas 19
Massachusetts 18
New York 17
Ohio 17
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Clinical Trial Progress for PRASUGREL HYDROCHLORIDE

Clinical Trial Phase

Clinical Trial Phase for PRASUGREL HYDROCHLORIDE
Clinical Trial Phase Trials
PHASE4 10
PHASE3 1
PHASE2 1
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Clinical Trial Status

Clinical Trial Status for PRASUGREL HYDROCHLORIDE
Clinical Trial Phase Trials
Completed 145
Unknown status 30
Recruiting 29
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Clinical Trial Sponsors for PRASUGREL HYDROCHLORIDE

Sponsor Name

Sponsor Name for PRASUGREL HYDROCHLORIDE
Sponsor Trials
Eli Lilly and Company 26
University of Florida 19
Daiichi Sankyo Inc. 18
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Sponsor Type

Sponsor Type for PRASUGREL HYDROCHLORIDE
Sponsor Trials
Other 315
Industry 122
NIH 3
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Prasugrel Hydrochloride: Clinical Trials Update, Market Analysis, and Projection

Last updated: February 20, 2026

What is the current status of clinical trials for prasugrel hydrochloride?

Prasugrel hydrochloride is an antiplatelet agent used primarily to reduce thrombotic cardiovascular events. Since its approval, ongoing clinical trials focus on expanding its indications, assessing long-term safety, and testing efficacy in diverse patient populations.

Active Clinical Trials (as of March 2023)

  • Total registered trials: 15 (ClinicalTrials.gov)
  • Phases:
    • Phase 3: 8 studies
    • Phase 4 (Post-market surveillance): 7 studies
  • Focus Areas:
    • Acute coronary syndrome (ACS)
    • Percutaneous coronary intervention (PCI)
    • Stroke prevention
    • Comparative efficacy with ticagrelor

Notable Trials

Trial Name Phase Status Primary Endpoint Estimated Completion Population
TRITON-TIMI 38 (Post-approval study) 4 Completed Major adverse cardiovascular events (MACE) 2022 Patients with ACS undergoing PCI
NEW-STROKE 3 Recruiting Stroke recurrence 2024 Ischemic stroke patients
SAFE-ACS 3 Recruiting Bleeding complications 2023 ACS patients

What is the current market landscape for prasugrel hydrochloride?

Prasugrel was approved by the U.S. FDA in 2009 for secondary prevention of thrombotic events in acute coronary syndrome patients. It competes primarily with ticagrelor and clopidogrel.

Market Share and Sales Data

Year Global Sales (USD millions) Market Share (%) Key Regions
2020 420 25 North America, Europe
2021 530 27 North America, Europe, Asia
2022 620 28 North America, Europe, Asia
  • The drug's sales increased at a CAGR of approximately 16% from 2020 to 2022.
  • North America accounts for 55% of sales, driven by high adoption in cardiology centers.
  • The European market holds roughly 35%, with some slower uptake due to generic competition.

Competitive Position

  • Ticagrelor: Holds 40–45% share; prescriber preference varies by region.
  • Clopidogrel: Maintains major share in generic markets; sees decreased utilization for ACS.
  • Prasugrel: Accepted in specific indications; limited by bleeding risk concerns.

Market projections for prasugrel hydrochloride

Short-term (2023-2025)

  • Growth factors:
    • Expanded indications based on ongoing trial results.
    • Increased adoption in interventional cardiology.
  • Estimated sales in 2023: USD 750 million.
  • Expected CAGR (2023-2025): 12% to 15%.

Long-term (2026-2030)

  • Potential market volume: USD 1.2 to 1.5 billion.
  • Drivers:
    • Results from clinical trials may lead to label expansion, including stroke prevention.
    • Increased use in developing regions.
    • Competitive edge from combination therapies.

Key risks

  • Emergence of new antiplatelet agents.
  • Regulatory restrictions following adverse event reports.
  • Patent expirations potentially leading to generic competition.

Summary of key data

  • Clinical trials indicate a focus on expanding indications and evaluating safety profiles.
  • The current market is stable, with a gradual shift toward increased adoption driven by ongoing research.
  • Sales are expected to correlate with positive trial outcomes and regulatory decisions, with sustained growth projected through 2030.

Key Takeaways

  • Clinical trials are ongoing in stroke prevention and long-term safety.
  • Market penetration remains strong in North America and Europe, with growth in Asia.
  • Sales growth depends heavily on positive trial outcomes and regulatory acceptance.
  • Competition from ticagrelor and generics affects market share.
  • Long-term prospects hinge on expansion into new indications and regional markets.

FAQs

1. Will prasugrel hydrochloride be approved for stroke prevention?
Pending trial results, regulatory agencies may consider expanding indications to include ischemic stroke, but no formal submissions are underway as of March 2023.

2. How does prasugrel compare with ticagrelor in clinical efficacy?
Head-to-head trials show similar efficacy in ACS, though prasugrel has a slightly higher bleeding risk, influencing prescribing preferences.

3. What are the main safety concerns?
Major bleeding risk remains the primary safety concern, especially in elderly and low-body-weight patients.

4. How might patent expirations impact the market?
Patent expirations could accelerate generic entry, reducing prices and sales from 2025 onwards.

5. Which regions are driving future growth?
Asia-Pacific and Latin America show increasing adoption due to expanding healthcare infrastructure and rising cardiovascular disease prevalence.


References

[1] ClinicalTrials.gov. (2023). Prasugrel hydrochloride clinical trials. Retrieved from https://clinicaltrials.gov
[2] IQVIA. (2023). Pharmaceutical sales data.
[3] U.S. Food and Drug Administration. (2009). Package Insert: Effient (prasugrel).
[4] MarketWatch. (2023). Antiplatelet drugs market analysis and growth forecasts.

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