Technology Assessment
Speciality
Output Type
Expected
Technology Assessment
Speciality
Output Type
Expected
What were we asked to look at?
The Scottish Health Technologies Group (SHTG) has been asked to review the evidence for clopidogrel genotype testing after ischaemic stroke or transient ischaemic attack (TIA). Draft diagnostics guidance from NICE (2024) recommends offering genotype testing to people who are being considered for clopidogrel after having an ischaemic stroke or TIA. This SHTG assessment will summarise the NICE guidance and capture additional evidence relevant to decision making in Scotland (for example, local data, patient views, and cost implications).
Why is this important?
In 2021–2022, there were 9,549 confirmed ischaemic strokes and an estimated 3,763 TIAs in Scotland. People who have had a stroke or TIA are at increased risk of having another stroke. They are often prescribed an antiplatelet medication, such as clopidogrel, to reduce their risk of stroke recurrence. An estimated 28.7% of people prescribed clopidogrel in the UK are resistant. This means they cannot metabolise clopidogrel and their stroke risk is not reduced. Clopidogrel resistance can be caused by mutations in the CYP2C19 gene. Relevant mutations can be identified using genotype testing. This allows clinicians to prescribe a more effective antiplatelet medication for affected patients.
Referred by
The Accelerated National Innovation Adoption (ANIA) collaborative