In a retrospective analysis conducted over a 13-year period, the irreversible blockade of the P2Y12 receptor (P2Y12R) by clopidogrel was found to be associated with an increased risk of gastrointestinal (GI) symptoms in female irritable bowel syndrome (IBS) patients, “although age or sex alone contributes to symptomatology.”     

Data from the Wexner Medical Center (the author’s institutional database) was utilized to obtain IBS patient demographics, GI symptoms reported, and clopidogrel use. The study authors noted that “Logistic regression models were used to characterize symptoms in clopidogrel versus no-clopidogrel IBS-groups, adjusting for Age and Sex differences.” Additionally, P2Y12R distribution in the human gut was assessed in a separate study.

A total of 7,217 IBS patients were identified in the database, 456 of which had received clopidogrel and 6,761 who had not. The results showed a higher proportion of patients with GI symptoms on clopidogrel (68%) compared to controls (60%, P=0.0011) that were females (70% vs. 60%, P=0.0003) not males (61 vs. 60%; P=0.8312).”

Data analysis also revealed that clopidogrel use was associated with an increased risk of GI symptoms (P<0.0001) for pain, constipation, and gastroparesis (P<0.0001), as well psychogenic pain (P=0.0006) in females. The authors noted that age- or sex-adjusted models “influenced” at least one GI symptom, such as pain, constipation, diarrhea, or flatulence. The study authors also stated that “P2Y12R immunoreactivity was abundant in human ENS; glial-to-neuron ratio of P2Y12Rs expressed in Females >> Males.”

Clopidogrel use was found to be associated with an increased risk of GI symptoms in female IBS patients, even though age or sex contributes to symptomatology. “Prospective studies can determine clinical implications of P2Y12Rs in IBS,” concludes the study.

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