InforMatrix: ADP antagonists in acute coronary syndromes

InforMatrix is an interactive matrix model, in which pharmacotherapeutic strategies are supported in a rational manner, by means of a transparent selection methodology.In this paper, InforMatrix is applied to ADP antagonists, including clopidogrel, prasugrel and ticagrelor. These drugs are important additions to the treatment of acute coronary syndromes. The drugs are compared using the following selection criteria: efficacy, safety, tolerability, ease of use, applicability and cost. All direct comparative studies, as well as placebo-controlled or double-blind comparisons with other drugs, were used in the assessment.By means of the interactive program, users may assign their own individual weight to each criterion and to the properties of the individual drugs, which stimulates concrete discussions on the relative importance of the various aspects of the drugs. When applied to ADP antagonists, the discussion focuses on the documentation of relative efficacy, safety and acquisition cost. The extensive clinical experience with clopidogrel must be balanced against the potential advantages of the other two compounds concerning efficacy. In those countries where generic clopidogrel is available, there are also major differences in acquisition cost between generic clopidogrel and patented prasugrel and ticagrelor. The interactive program provides the opportunity to quantify existing differences in opinion on the (importance of) various properties of the drugs, which greatly facilitates concrete discussions and rational formulary decision making.