News | Antiplatelet and Anticoagulation Therapies | April 01, 2016

Updated ACC-AHA Guideline Recommends Brilinta in Acute Coronary Syndrome

First major U.S. guideline to include expanded indication for Brilinta in patients with a heart attack beyond one year

Brilinta, ticagrelor, ACC-AHA guideline, acute coronary syndrome

April 1, 2016 — AstraZeneca confirmed that the American College of Cardiology (ACC) and American Heart Association (AHA) have released a treatment guideline on the duration of dual antiplatelet therapy (DAPT). Brilinta (ticagrelor) is now preferred over clopidogrel for the management of patients with acute coronary syndrome (ACS) who have received a coronary stent, and in non-ST elevation acute coronary syndrome (NSTE-ACS) patients treated with medical therapy alone (Class IIa LOE: B-R). This update is the first time the ACC/AHA has recommended Brilinta over clopidogrel for patients who have experienced a ST-elevation myocardial infarction (STEMI).

The update is also the first U.S. guideline to provide the medical community with insights drawn from the PEGASUS-TIMI 54 trial. The guideline supports continuation of P2Y12 therapy beyond 12 months in prior MI patients who are not at high bleeding risk (Class IIb LOE: A).

The U.S. Food and Drug Administration (FDA) approved Brilinta at a 60mg dose for patients with a history of heart attack in September 2015. Brilinta is the only P2Y12 inhibitor that has been approved by the FDA in the past 10 years, for long-term use in patients with a history of MI. In the United States, it is indicated to reduce the rate of cardiovascular death, MI and stroke in patients with ACS or a history of MI. For at least the first 12 months following ACS, it has been proven superior to clopidogrel. Brilinta also reduces the rate of stent thrombosis in patients who have been stented for treatment of ACS.

This update comes ahead of the ACC's 65th Annual Scientific Sessions. Data will be presented on two new sub-analyses from the PEGASUS trial. The sub-analyses include prior MI patients with either peripheral artery disease (PAD) or diabetes.

In the second half of 2016, data are expected from the ongoing EUCLID trial in PAD, which is the fourth trial to read-out from the PARTHENON program, assessing the potential of Brilinta in additional high-risk patient populations.

Brilinta is not approved for the prevention of cardiovascular events in patients with PAD, stroke or diabetes who have not experienced a prior MI.

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