POPULATION PHARMACOKINETICS OF PANTOPRAZOLE IN PATIENTS ON DUAL ANTIPLATELET THERAPY FOLLOWING ACUTE CORONARY SYNDROME

Abstract

This study investigates factors influencing pantoprazole pharmacokinetics (PK) in patients with acute coronary syndrome (ACS) undergoing dual antiplatelet therapy (DAPT) comprising acetylsalicylic acid and clopidogrel, alongside concomitant pantoprazole to mitigate gastrointestinal risks. We conducted a prospective analysis on 93 ACS patients, assessing pantoprazole PK parameters and their correlation with C-reactive protein (CRP) levels, indicative of inflammation. Blood samples for pantoprazole concentration and CRP levels were collected according to a predefined schedule, post-oral pantoprazole administration at steady state. The study highlights a notable influence of CRP levels on pantoprazole clearance, underscoring inflammation’s impact on drug metabolism. Elevated CRP was associated with altered pantoprazole pharmacokinetics, suggesting that inflammatory status significantly contributes to metabolic variability in this patient population. Our findings suggest the need for personalized pantoprazole dosing in ACS patients on DAPT, considering the inflammatory status as reflected by CRP levels. This approach could optimize therapeutic efficacy and minimize adverse effects, advancing personalized treatment strategies in the management of ACS.