New Drug Update 2010-2011 Faculty Disclaimer - CME Conferences
New Drug Update 2010-2011 Faculty Disclaimer - CME Conferences
New Drug Update 2010-2011 Faculty Disclaimer - CME Conferences
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2 nd Annual Essentials in Primary Care<br />
Fall Conference<br />
Friday, November 11, <strong>2011</strong><br />
Ticagrelor - Brilinta<br />
Effects of Ticagrelor on Other Medications:<br />
• Patients receiving more than 40 mg per day of<br />
simvastatin or lovastatin may be at increased risk of<br />
statin-related adverse effects.<br />
• Monitor digoxin levels with initiation of or any change<br />
in ticagrelor because of P-glycoprotein transporter<br />
inhibition<br />
Concomitant Aspirin Maintenance Dose: In PLATO, use of<br />
ticagrelor with maintenance doses of aspirin above 100<br />
mg decreased the effectiveness of ticagrelor. Therefore,<br />
after the initial loading dose of aspirin (usually 325 mg),<br />
use ticagrelor with a maintenance dose of aspirin of 75-<br />
100 mg<br />
Ticagrelor – Brilinta<br />
N Engl J Med 2009;361:1045-57<br />
• PLATO Trial, a randomized double-blind study comparing<br />
ticagrelor (180 mg LD then 90 mg BID)(N=9333) to<br />
clopidogrel (300mg LD then 75 mg QD) (N=9291), both<br />
given in combination with aspirin (75-100 mg QD but<br />
higher doses were allowed per investigator) and other<br />
standard therapy, in patients with acute coronary<br />
syndromes (ACS). Patients were treated for at least 6<br />
months and for up to 12 months.<br />
– Patients were predominantly male (72%) and Caucasian (92%).<br />
About 43% of patients were >65 years and 15% were >75 years.<br />
– Primary endpoint was the composite of first occurrence of<br />
cardiovascular death, non-fatal MI (excluding silent MI), or nonfatal<br />
stroke. The components were assessed as secondary<br />
endpoints<br />
– Median exposure to study drug was 277 days<br />
Wayne Weart<br />
<strong>New</strong> <strong>Drug</strong> <strong>Update</strong> Part I