Extended Ticagrelor Shows Cardiovascular Risk Reduction

New results from the phase III PEGASUS-TIMI 54 trial have shown that ticagrelor (Brilinta, AstraZeneca), a direct-acting P2Y₁₂ receptor antagonist, lowered the risk of cardiovascular death by 29% (p=0.0041).

“The conclusion for both clinicians and patients at high-risk of CV death post-MI is clear,” Mikael Dellborg (pictured), MD, a professor of cardiology at the University of Gothenburg, and a member of the Steering Committee of the PEGASUS-TIMI 54 trial said in a statement. “Treatment with Brilinta 60 mg, either as continuation therapy after the initial 12-month post-event period, or with as limited interruption as possible, is associated with a clear and [favorable] benefit-risk ratio for this population of patients.”

Patients taking low-dose aspirin at risk for an atherothrombotic event and cardiovascular death were given 60 mg of ticagrelor twice daily, compared to placebo. They were given ticagrelor within 2 years of experiencing a myocardial infarction (MI) or within 1 year of stopping adenosine diphosphate (ADP) antiplatelet treatment.

Results highlighted the potential for protective cardiovascular benefits when 60 mg ticagrelor was used in the long term as opposed to the standard 12-month treatment period, post event.

“This new insight is potentially practice-changing, as while more than seven million people worldwide suffer a heart attack each year, we know that fewer than half receive adequate long-term treatment to reduce their risk of further CV events,” Dellborg said.

In addition to decreasing cardiovascular death risk by 29%, sub-analysis of the trial showed that all causes of death were reduced 20%, and there was a 20% reduction in the composite of cardiovascular death, MI, or stroke.

Major bleeding rates were reportedly consistent with the known safety profile of ticagrelor.

“The Phase III PEGASUS-TIMI 54 trial continues to provide valuable data and insights with the potential to benefit both healthcare professionals and their patients,” Elisabeth Björk, Vice President, Head of Cardiovascular and Metabolic Diseases (CVMD), Global Medicines Development, AstraZeneca, said in a statement. “The results reinforce the importance of our continued investment in the science, helping to understand better the unique CV and mortality benefits that our medicines, such as Brilinta, can provide for the millions of patients living with cardiovascular disease, the leading cause of death globally.”

The full results of the PEGASUS-TIMI 54 trial are expected to be presented at the European Society of Cardiology (ESC) Congress in Barcelona, Spain.

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