ABCIXIMAB (C7E3 FAB) - A REVIEW OF ITS PHARMACOLOGY AND THERAPEUTIC POTENTIAL IN ISCHEMIC-HEART-DISEASE

Abciximab (c7E3 Fab) is a chimaeric human-murine monoclonal antibody F ab (fragment antigen binding)fragment. It binds to the platelet glycop rotein IIb/IIIa receptor and inhibits platelet aggregation. In two dou ble-blind placebo-controlled trials, abciximab therapy reduced the inc idence of ischaemic complications during the initial postoperative per iod (30 days or until hospital discharge) in high-risk patients underg oing percutaneous coronary angioplasty or directional atherectomy. It also reduced the incidence of clinical restenosis compared with placeb o during longer term (6 months) follow-up of these patients. Although abciximab delayed the need for coronary artery bypass graft surgery, i t did not reduce the proportion of patients ultimately requiring this procedure. The drug was generally well tolerated in clinical trials, w ith bleeding complications being the major adverse event. Abciximab is at an early stage of its clinical introduction anti, not surprisingly , some aspects of its use remain to be further assessed. Nevertheless, results show the addition of abciximab to standard aspirin plus hepar in therapy during core nary angioplasty or directional atherectomy imp roves the outcome of the revascularisation procedure in patients with a high risk of subsequent acute ischaemic complications. The results o f further trials defining the optimum dosage of heparin when administe red with abciximab, and evaluating the role of abciximab in a wider ra nge of patients, are eagerly awaited.