Real-world study of Brilinta shows non-superiority over Plavix in percutaneous coronary intervention.- AstraZeneca

A large US and Korean real-world study indicates that Brilinta (ticagrelor) from AstraZeneca may not have an advantage over Plavix (clopidogrel) as part of a dual antiplatelet therapy (DAPT) regimen when it comes to treating ACS patients who have undergone percutaneous coronary intervention (PCI) in everyday practice. Net adverse clinical events (NACE)—encompassing recurrent MI, revascularization, ischemic or hemorrhagic stroke, and GI bleeding—were not significantly different between the ticagrelor and clopidogrel groups at 1 year. Ticagrelor, however, was associated with greater risks of hemorrhagic stroke, GI bleeding, and dyspnea, without an offsetting lower risk of ischemic events, compared with clopidogrel. The findings show no benefit (and the suggestion of a harm) from ticagrelor, even taking into account that people are more likely to stop taking ticagrelor which is the more-expensive drug. But additional research is needed to compare the two drugs in patients with ACS after PCI, the researchers say. Results were presented in the October 27, 2020, issue of JAMA.See: "Association of ticagrelor vs clopidogrel with net adverse clinical events in patients with acute coronary syndrome undergoing percutaneous coronary intervention." You SC, Rho Y, Bikdeli B, et al. JAMA. 2020;324:1640-1650.