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Pharmacodynamic effects of indobufen compared with aspirin in patients with coronary atherosclerosis

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This study aimed to investigate the pharmacodynamic effects of indobufen and low-dose aspirin in patients with coronary atherosclerosis.


In the first phase, 218 patients with coronary atherosclerosis were randomly assigned to receive aspirin 100 mg once daily (standard dose); 100 mg once every 2 days; 100 mg once every 3 days; 50 mg twice daily; 75 mg once daily; 50 mg once daily; or indobufen 100 mg twice daily for 1 month. In the second phase, 20 healthy subjects were treated with indobufen 100 mg twice daily for 1 week followed after a 2-week washout by aspirin 100 mg once daily for 1 week. The primary outcome was arachidonic acid-induced platelet aggregation (PLAA), and the secondary outcomes included plasma thromboxane B2 (TXB2) and urinary 11-dehydro-TXB2 (11-dh-TXB2) levels at the end of each treatment. 


In the first phase, compared with aspirin 100 mg once daily: all aspirin groups had similar suppression of PLAA whereas indobufen group had significantly less suppressed PLAA. Aspirin given every second or third day, and indobufen produced less suppression of plasma TXB2. All treatment regimens produced similar inhibition of 11-dh-TXB2. In the second phase, compared with aspirin, indobufen produced less suppression of plasma TXB2 at 8 h and 12 h after the last dose.


Aspirin 50 mg twice daily, 75 mg once daily, and aspirin 50 mg once daily produce antiplatelet effects that are similar to aspirin 100 mg once daily. Aspirin given less often than once daily and indobufen 100 mg twice daily do not suppress platelets as effectively as aspirin 100 mg once daily.

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.


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This work was supported by grants from the Jiangsu Province’s Key Provincial Talents Program (ZDRCA2016013), the Second Level of 333 High Level Talent Training Project in Jiangsu Province (BRA2019099), the Nanjing Science and Technology Development Plan 2016 (201605071), the Special Fund for Key R & D Plans (Social Development) of Jiangsu Province (BE2019754), and a Project Funded by the Priority Academic Program Development of Jiangsu Higher Education Institutes (PAPD).

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Authors and Affiliations



Mingwen Yang, Lianlian Mei, and Chunjian Li designed the study. Mingwen Yang, Lianlian Mei, Zekang Ye, and Inam Ullah performed experiments. Chuchu Tan, Guoyu Wang, Qian Gu, Yi Lu, and Jianling Bai analyzed the data. Samee Abdus, Lu Shi, and Xiaoxuan Gong discussed the results. Mingwen Yang wrote the original manuscript. John W Eikelboom and Chunjian Li reviewed and edited the manuscript.

Corresponding author

Correspondence to Chunjian Li.

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Ethics approval

This study was approved by the Ethics Committee of the First Affiliated Hospital of Nanjing Medical University (Approval Number2017-SR-226).

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All enrolled subjects signed the informed consent form (ICF) before the study was conducted.

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All co-authors have reviewed and approved this manuscript for publication.

Conflict of interest

Dr. Chunjian Li received the donation of indobufen from Huadong Medicine Co., Ltd., China.

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Yang, M., Ye, Z., Mei, L. et al. Pharmacodynamic effects of indobufen compared with aspirin in patients with coronary atherosclerosis. Eur J Clin Pharmacol 77, 1815–1823 (2021).

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