Led by Robert Storey, Professor of Cardiology at the University of Sheffield’s Department of Cardiovascular Science, some researchers in the United Kingdom are promoting the adoption of a new drug – ticagrelor - for the treatment acute coronary syndrome or ACS. Acute coronary syndrome is caused when a coronary event such as a heart attack reduces blood flow to the heart. (Mayo Clinic 1.)
Currently, the standard treatment is clopidogrel. Marketed in the U.S. under the brand name Plavix, clopidogrel is prescribed to patients who’ve experienced a heart attack or stroke to prevent the formation of blood clots. In some cases, it may be prescribed to patients hospitalized due to chest pain or those with poor circulation or peripheral artery disease, or PAD. Preventing blood clots lowers a heart patient’s risk of a subsequent heart attack, stroke, or premature death. (Clopidogrel 1.)
Storey and other proponents of ticagrelor believe that it’s more effective than Plavix at reducing subsequent heart attacks and preventing premature death. Based on findings from A Study of Platelet Inhibition and Patient Outcomes or PLATO study, researchers believe that in the first year following a heart attack one in five lives can be saved. Ticagrelor appears to be effective across all age spectrums and researchers believe its use will save lives. Researchers also point to the fact that in the UK alone, approximately 25 percent of the population is genetically resistant to Plavix, causing the drug to be less effective, which underscores the need to adopt ticagrelor as the standard treatment. Use of ticagrelor is not affected by this genetic marker. (ScienceDaily 1.) PLATO is a large, multi-national trial involving 18, 643 participants from 43 countries.
A follow up trial – PEGASUS – has begun to study the effectiveness of ticagrelor after the first year following a heart attack. A multi-national study, PEGASUS will ultimately consist of 21,000 participants and will examine the effectiveness of ticagrelor when added to aspirin. Another study – ATLANTIC – will examine the effectiveness of treating patients with ticagrelor during ambulance transport.
Ticagrelor is currently under review by the U.S. Food and Drug Administration in the U.S. and the manufacturer, AstraZeneca, is pushing for approval in 2011. Approved for use in the UK in December, 2010, ticagrelor has been approved for use in 30 countries with approval pending in 21 additional countries. (Brilinta 1.)
University of Sheffield (2011, June 13). One in five heart-attack deaths could be prevented with new drug, findings show. ScienceDaily. Retrieved June 19, 2011, from http://www.sciencedaily.com/releases/2011/06
Brilinta: US FDA Assigns New PDUFA Date for Brilinta (ticagrelor tablets), Drugs.com, Feb 2011, http://www.drugs.com/nda/brilinta_110204.html
Kristi Monson, PharmD, Arthur Schoenstadt, MD, Clopidogrel, MEdTV.com, 11 Aug 2008, http://heart-disease.emedtv.com/clopidogrel/clopidogrel.html
Acute Coronary Syndrome, The Mayo Clinic, 04 Nov 2010, http://www.mayoclinic.com/health/acute-coronary-syndrome/DS01061
Brilinta (ticagrelor) better in reducing heart attacks and strokes than Plavix (clopidogrel), says AstraZeneca, DanceWithShadows.com, 11 May 2009, http://www.dancewithshadows.com/pillscribe/brilinta-ticagrelor-better-in-reducing-heart-attacks-and-strokes-than-plavix-clopidogrel-says-astrazeneca/
Reviewed June 20, 2011
Edited by Alison Stanton