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Master Thesis

Impact du clopidogrel sur le CD40 ligand soluble plasmatique chez des patients atteints de lupus érythémateux systémique : résultats de l’étude pilote de phase I/II « CLOPUS »

Abstract : Objective: CD40–CD40 ligand (CD40L) interactions are involved in systemic lupus erythematosus (SLE) pathogenesis. As platelets represent the main reservoir of soluble CD40L (sCD40L), we performed a pilot study to assess the impact of the platelet inhibitor clopidogrel on plasma sCD40L levels in SLE patients. Methods: we performed a single-arm, open-label, phase I/II trial of clopidogrel in patients with quiescent SLE (no flare within 3 months before inclusion). Patients received clopidogrel 75 mg per day for 12 weeks. The primary outcome was the change in the plasma sCD40L concentration at 12 weeks after inclusion. Patients were followed for 4 weeks after the final dose. This study was registered on ClinicalTrials.gov, NCT02320357. Results: Between August 2015 and April 2017, 24 patients were screened and 18 were included. The mean plasma sCD40L concentration decreased during the first week of treatment without achieving statistical significance (p = 0.09) and then plateaued until week 12 (p = 0.34). One day of clopidogrel significantly reduced platelet activation, as assessed by CD154+ (CD40L) and CD62+ (P-selectin) expression levels (p = 0.002). Two patients discontinued the treatment due to an adverse event or personal decision. Clopidogrel was well tolerated, with only a single serious bleeding incident (menorrhagia grade 3). Conclusion: clopidogrel tends to decrease platelet activation in SLE patients, but its effect on the sCD40L concentration remains to be demonstrated. A more extensive controlled study is needed to confirm our results before considering a randomized clinical trial.
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https://dumas.ccsd.cnrs.fr/dumas-03008112
Contributor : Médecine Ub <>
Submitted on : Monday, November 16, 2020 - 4:21:12 PM
Last modification on : Saturday, December 19, 2020 - 3:12:50 AM

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  • HAL Id : dumas-03008112, version 1

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Guillaume Vial. Impact du clopidogrel sur le CD40 ligand soluble plasmatique chez des patients atteints de lupus érythémateux systémique : résultats de l’étude pilote de phase I/II « CLOPUS ». Sciences du Vivant [q-bio]. 2020. ⟨dumas-03008112⟩

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