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Pilagrel (HIE-103) is a small molecule antiplatelet agent developed by Hefei Medical Engineering Pharmaceutical for the treatment of acute ischemic stroke. It exerts its therapeutic effect through a dual mechanism of action: it acts as a thromboxane A2 (TXA2) synthase inhibitor and a TXA2 receptor (TP receptor) antagonist. By simultaneously reducing the production of TXA2 and blocking its interaction with the TP receptor on platelets and vascular smooth muscle cells, pilagrel effectively inhibits platelet aggregation and alleviates vasoconstriction. This dual approach is intended to provide superior antithrombotic efficacy compared to single-target agents. The drug is currently in Phase III clinical development in China as an intravenous injection for patients with acute thrombotic ischemic stroke within 48 hours of onset.
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