MONDAY, June 27 (HealthDay News) -- Brilinta, an experimental
anti-clotting medication currently awaiting U.S. Food and Drug
Administration approval, performed better than the industry
standard, Plavix, when used in tandem with low-dose aspirin, a new
Heart patients who took Brilinta (ticagrelor) with low-dose
aspirin (less than 300 milligrams) had fewer cardiovascular
complications than those taking Plavix (clopidogrel) plus low-dose
aspirin, researchers found.
However, patients who took Brilinta with higher doses of aspirin
(more than 300 milligrams) had worse outcomes than those who took
Plavix plus high-dose aspirin, the investigators reported.
Antiplatelet drugs are used to prevent potentially dangerous
blood clots from forming in patients with acute coronary syndrome,
including those who have had a heart attack.
Brilinta has already been approved for use in many other
countries. In July 2010, an FDA panel voted 7-to-1 to approve the
use of Brilinta for U.S. patients undergoing angioplasty or
stenting to open blocked arteries, but the approval process is
The panel's recommendation was based in part on prior findings
from this study, called the Platelet Inhibition and Patient
Outcomes (PLATO) trial.
In this latest analysis of PLATO findings, researchers found
that patients who took Brilinta with low-dose aspirin were 16
percent less likely than those who took Plavix with low-dose
aspirin to have a heart attack or stroke, or to die within a
The findings were reported Monday in an American Heart
Association online conference.
One expert said the new information is valuable.
"The study highlights that if one chooses to use ticagrelor in subjects with acute coronary syndromes, it would be logical to use aspirin 81 milligrams per day (and not 325 mg daily)," said Dr. Jeffrey S. Berger, assistant professor of medicine and director of cardiovascular thrombosis at NYU Langone Medical Center in New York City. "Of note, there is little reason to ever use aspirin 325 mg except in the acute setting of a heart attack or stroke," he added. "A higher aspirin dose (325 mg versus 81 mg) increases the risk of bleeding without increasing the efficacy of the drug."
A study author agreed that for most patients, using the drug
with a lower dose of aspirin is usually warranted.
"Patients with acute coronary syndrome have options to prevent recurrent events," study lead author Dr. Kenneth W. Mahaffey, co-director of cardiovascular research at the Duke Clinical Research Institute, and associate professor of medicine at Duke University Medical Center, said in an AHA news release. "Physicians choosing to use ticagrelor in countries where it is approved and available should consider using a low-dose of maintenance aspirin with the drug."
The data and conclusions of the research should be viewed as
preliminary until published in a peer-reviewed journal.
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