Brilinta monotherapy reduced the risk of clinically relevant bleeding compared to aspirin + Brilinta in high-risk coronary patients according to phase IV independent TWILIGHT trial. AstraZeneca

One subgroup analysis (TWILIGHT-DM) included patients with diabetes who had undergone a successful percutaneous coronary intervention (PCI), a procedure to open a blocked or narrowed coronary artery. The other (TWILIGHT-COMPLEX) included patients who had successfully undergone a complex PCI. In both subgroups, Brilinta monotherapy was associated with lower rates of clinically relevant bleeding without increasing the risk of ischaemic events, between months three and 15 post PCI. This was compared to dual antiplatelet therapy (DAPT) with aspirin plus Brilinta. These data were consistent with the overall trial results. 

Comment: Patients receiving Brilinta monotherapy in TWILIGHT-DM study had a 35% lower risk of bleeding and a similar risk of ischaemic events compared to those receiving DAPT ( Brilinta + aspirin) in the diabetes subgroup. Patients receiving Brilinta monotherapy in TWILIGHT-COMPLEX study post PCI , had a 46% lower risk of bleeding and a similar risk of ischaemic events compared to those receiving DAPT in the complex PCI subgroup.