In short
Tirofiban is a medicine that reduces blood clotting by blocking a receptor on platelets. It is being studied in a Phase 2 clinical trial for people with a type of heart attack called STEMI, where it is given directly into a coronary artery during a procedure to open the blocked vessel. The REVITALISE study will include 280 participants and will compare tirofiban with adenosine.
Tirofiban is a medicine that reduces blood clotting. It belongs to a group of drugs called glycoprotein IIb/IIIa receptor antagonists, which act on platelets, the small blood cells that help blood to clot. It is also known by the trade name Aggrastat and the development code L-700,462.
Key points
- Tirofiban is a glycoprotein IIb/IIIa receptor antagonist that reduces blood clotting.
- The REVITALISE study is testing tirofiban in people with STEMI and microvascular obstruction.
- The trial is in Phase 2 and has been authorised to begin.
- 280 participants are planned for the study.
- Tirofiban is given intracoronary, directly into a heart artery, during a procedure called PPCI.
- The main measure is the change in left ventricular ejection fraction between 24 to 72 hours and 6 months after the procedure.
What is tirofiban?
Tirofiban is a chemically synthesised medicine that acts as a reversible antagonist of fibrinogen binding to the GP IIb/IIIa receptor on platelets. It is classified as a fibrinogen receptor antagonist, also called a glycoprotein IIb/IIIa receptor antagonist. Other names for the same substance include tirofiban hydrochloride, tirofiban HCl, and tirofiban hydrochloride monohydrate.
How does tirofiban work?
Platelets stick together to form blood clots. Tirofiban blocks a receptor on the surface of platelets called the glycoprotein IIb/IIIa receptor. Fibrinogen, a protein in the blood, normally binds to this receptor to link platelets together. By preventing fibrinogen from binding, tirofiban reduces platelet aggregation and therefore reduces the formation of blood clots. This action is reversible, meaning the effect wears off after the medicine is cleared from the body.
Which conditions is tirofiban used or studied for?
- STEMI (ST elevated myocardial infarction) — a serious type of heart attack where a coronary artery is completely blocked. Tirofiban is being studied in people with STEMI who also have microvascular obstruction, a condition where the smallest blood vessels in the heart muscle remain blocked even after the main artery is reopened.
- Ischemic stroke — a condition where a blood clot blocks a blood vessel in the brain. Research has examined the safety and efficacy of tirofiban combined with mechanical thrombectomy, a procedure to remove the clot, in people with this condition.
How is tirofiban given?
In the REVITALISE study, tirofiban is given as a solution for infusion. The product used in the trial is tirofiban Ibisqus 50 micrograms per millilitre infusion solution. It is administered by intracoronary use, which means it is delivered directly into a coronary artery during a heart procedure. The dose used in the study is 25 micrograms per kilogram.
What do the clinical trials show?
One clinical trial of tirofiban is listed in the registry. The REVITALISE study is a Phase 2 interventional trial that has been authorised but is not yet recruiting. It plans to enrol 280 participants.
The study is testing a system called CoFI as a platform for intracoronary infusion of therapeutic agents. The aim is to treat and relieve microvascular injury in people with ST elevation acute coronary syndrome who have been diagnosed with microvascular obstruction. Tirofiban and adenosine are the two medicines being compared.
What is the trial measuring?
The primary outcome is the absolute change in left ventricular ejection fraction, a measure of how well the heart pumps blood. This is measured by transthoracic echocardiography, an ultrasound scan of the heart. The change is assessed between 24 to 72 hours after primary percutaneous coronary intervention, the procedure to open the blocked artery, and 6 months after the procedure. All assessments will be performed blinded to treatment group assignment, meaning the people measuring the results do not know which treatment each participant received.
Who can take part in the trial?
The trial includes people with STEMI, a type of heart attack where the ST segment on an electrocardiogram is elevated, indicating a complete blockage of a coronary artery. Participants must have been diagnosed with microvascular obstruction after primary percutaneous coronary intervention. The study also involves people with ST elevation acute coronary syndrome, a broader term that includes STEMI.
What side effects are known?
The sources provided do not give a specific list of side effects for tirofiban. Research on tirofiban combined with mechanical thrombectomy in ischemic stroke has examined safety outcomes, but the detailed safety findings are not available in the provided material.