Glycoprotein IIb/IIIa inhibitors: The resurgence of tirofiban

Vascul Pharmacol. 2016 Mar:78:10-6. doi: 10.1016/j.vph.2015.07.008. Epub 2015 Jul 15.

Abstract

Glycoprotein (GP) IIb/IIIa inhibitors block platelet aggregation, reducing thrombotic events in acute coronary syndrome. They are most often utilized in patients who likely have an intracoronary thrombus. Tirofiban, eptifibatide, and abciximab are the three GP IIb/IIIa inhibitors approved for use in the United States. Each agent has unique pharmacological properties. They all have a rapid onset and are most often utilized in conjunction with heparin. Tirofiban, in particular, fell out of favor due to inferior dosing with its original Food and Drug Administration (FDA) approved indication, but has re-emerged in the market with a high-dose bolus regimen that is considered equally as effective as the FDA approved dosing regimens of other GP IIb/IIIa inhibitors. This review looks at pharmacological properties of all three agents, significant clinical trials associated with their use, and their place in current guidelines.

Keywords: Abciximab (ab-SIKS-ih-mab); Eptifibatide (ep-ti-FIB-ih-tide); Tirofiban (tye-roe-FYE-ban).

Publication types

  • Review

MeSH terms

  • Abciximab
  • Acute Coronary Syndrome / drug therapy*
  • Acute Coronary Syndrome / physiopathology
  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal / pharmacology
  • Antibodies, Monoclonal / therapeutic use
  • Eptifibatide
  • Humans
  • Immunoglobulin Fab Fragments / administration & dosage
  • Immunoglobulin Fab Fragments / pharmacology
  • Immunoglobulin Fab Fragments / therapeutic use
  • Peptides / administration & dosage
  • Peptides / pharmacology
  • Peptides / therapeutic use
  • Platelet Aggregation Inhibitors / administration & dosage
  • Platelet Aggregation Inhibitors / pharmacology
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Platelet Glycoprotein GPIIb-IIIa Complex / antagonists & inhibitors*
  • Practice Guidelines as Topic
  • Thrombosis / prevention & control
  • Tirofiban
  • Tyrosine / administration & dosage
  • Tyrosine / analogs & derivatives
  • Tyrosine / pharmacology
  • Tyrosine / therapeutic use

Substances

  • Antibodies, Monoclonal
  • Immunoglobulin Fab Fragments
  • Peptides
  • Platelet Aggregation Inhibitors
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Tyrosine
  • Tirofiban
  • Eptifibatide
  • Abciximab