September 8, 2010 – The increased effectiveness of ticagrelor (Brilinta) in overcoming high platelet reactivity as compared to the gold-standard of clopidogrel (Plavix) was shown in data presented last week at the European Society of Cardiology (ESC) Congress in Stockholm.
Pooled pharmacologic data from the ONSET/OFFSET and RESPOND trials compared high platelet reactivity between clopidogrel and ticagrelor use. This reactivity has been linked to complications following percutaneous coronary intervention (PCI).
Ticagrelor showed better platelet inhibition and faster offset than clopidogrel in the ONSET/OFFSET study. The RESPOND study also confirmed better platelet inhibition with ticagrelor in both clopidogrel responders and nonresponders. The effects of ticagrelor were observed within two hours, while clopidogrel took between four and eight hours.
One of the chief advantages of ticagrelor is its ability to reverse its effects quickly as compared to clopidogrel, which was also demonstrated in these data.
In July, the U.S. Food and Drug Administration (FDA) Cardiovascular and Renal Drugs Advisory Committee voted to recommend that the FDA approve ticagrelor for the reduction of thrombotic events in patients with acute coronary syndromes (ACS). The panel reviewed data from the PLATO (A Study of PLATelet Inhibition and Patient Outcomes) study, an outcomes trial of more than 18,000 patients whose data showed ticagrelor was superior to clopidogrel in the long-term reduction of cardiovascular events.
The FDA is expected to make an approval decision this month.