Study of Brilinta (ticagrelor) shows a reduction in cardiovascular-related deaths, heart attack, and stroke in patients who are at increased risk of cardiovascular events.
According to the latest statistics, in 2011 heart disease resulted in almost 70 000 deaths in Canada, and over 780 000 deaths in the United States. Heart disease encompasses disorders involving the cardiovascular system, including the heart and blood vessels, and stroke. In Canada a heart attack occurs every 7 minutes, while the estimate is every 34 seconds in the United States. Those who have previously had heart attack are at increased risk of further cardiovascular events.
Brilinta (ticagrelor) has been studied as a potential prevention strategy in patients with history of heart attack who are at increased risk of cardiovascular complications. Brilinta is an antiplatelet drug that acts by binding to, and inhibiting the P2Y12 receptor. As a result Brilinta prevents the clumping of platelets in the blood.
The results of the PEGASUS-TIMI 54 clinical trial were reported this month in the New England Journal of Medicine. The trial was designed to test whether long-term treatment with Brilinta (ticagrelor), in addition to low-dose aspirin can decrease the risk of major cardiovascular events in patients with a history of heart attack.
The study was conducted at over 1 100 centres, across 31 countries. Participants were included in the study if they had a heart attack between 1 and 3 years prior to enrollment, were 50 years of age or older, and had an additional high-risk characteristic (>65 years, diabetic, second heart attack, coronary artery disease, or chronic renal dysfunction). A total of 21 162 participants were assigned to one of three treatment groups: 90mg Brilinta twice daily, 60mg Brilinta twice daily, or placebo.
The results of the study showed that both doses of Brilinta significantly reduced the rates of cardiovascular death, heart attack, and stroke, compared with placebo control. Adverse events associated with the use of Brilinta were an increase in the rates of bleeding among patients.
A new study assessing Brilinta for prevention of cardiovascular events in patients with type 2 diabetes is currently enrolling participants in over 40 countries, including Canada and the United States. The participants will be eligible for the study if they are aged 50 years an older, have been diagnosed with type 2 diabetes, and have been on glucose lowering medication for at least 6 months. In addition, participants will have had either heart disease or previous stent or bypass surgery, placing them at higher risk of an additional cardiovascular event. Participants will be allocated to a treatment group of 90mg Brilinta twice daily, or placebo, for 35 months. The study will assess the effects of Brilinta on rates of cardiovascular-related death, heart attack, or stroke.
The Heart Foundation – Heart Disease Fact Sheet. Available from: http://www.theheartfoundation.org/heart-disease-facts/heart-disease-statistics/ Last Accessed: May 8, 2015.
The Heart and Stroke Foundation – Heart Disease Fact Sheet. Available from: http://www.theheartfoundation.org/heart-disease-facts/heart-disease-statistics/ Last Accessed: May 8, 2015.
Bonaca, MP, Bhatt, DL, Cohen, M, Steg, PG, Storey, RF, Jensen, EC, Magnani, G, Bansilal, S, Fish, P, Im, K, Bengtsson, O, Lic., P, Ophuis, TO, Budaj, A, Theroux, P, Ruda, M, Hamm, C, Goto, S, Spinar, J, Nicolau, JC, Kiss, RG, Murphy, SA, Wiviott, SD, Held, P, Braunwald, E, Sabatine, MS, for the PEGASUS-TIMI 54 Steering Committee and Investigators “Long-Term Use of Ticagrelor in Patients with Prior Myocardial Infarction” N Engl J Med 2015; 372:1791-1800
Brilinta Fact Sheet. Available from: https://www.brilinta.com/about-brilinta/antiplatelet-therapy.html Last Accessed: May 8, 2015.
Clinicaltrials.gov “A Study Comparing Cardiovascular Effects of Ticagrelor Versus Placebo in Patients With Type 2 Diabetes Mellitus (THEMIS)” Available from: https://www.clinicaltrials.gov/ct2/show/study/NCT01991795?term=ticagrelor&recr=Open&no_unk=Y&state1=NA%3ACA%3AON&rank=1&show_locs=Y#locn Last Accessed: May 8, 2015.
Image courtesy of thampapon1 at FreeDigitalPhotos.net
Written by Deborah Tallarigo, PhD