Effects of picotamide, an antiplatelet agent, on cardiovascular events in 438 claudicant patients with diabetes: a retrospective analysis of the ADEP study

Picotamide is an antiplatelet drug which inhibits thromboxane A₂ (TxA₂) synthase and antagonizes TxA₂ receptors. In the ADEP (Atherosclerotic Disease Evolution by Picotamide) trial, 2304 patients with peripheral obstructive arterial disease (POAD) were studied in a double-blind, placebo-controlled, 18-month, multicentre trial. In this study, 151 events (13.1%) occurred on placebo and 122 (10.6%) on picotamide (900  mg day⁻¹). The relative risk reduction was 19%, ( P =0.056). This paper reports a post-hoc analysis in a subgroup of 438 diabetic patients (picotamide=230; placebo=208). There were 32 vascular events on placebo (15%) and 18 on picotamide (8%) (relative risk reduction: 48%; 95% CI=26, 76; P =0.022). The results of this retrospective analysis suggest that a prospective study to investigate events in claudicant patients with diabetes mellitus is warranted.