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2 nd Annual Essentials in Primary Care Fall Conference Friday, November 11, 2011 Ticagrelor – Brilinta N Engl J Med 2009;361:1045-57 Endpoint Primary Composite (CV death, MI, CVA) Secondary Endpoints Ticagrelor N=9333 Clopidogrel N=9291 Hazard Ratio (95% CI) 9.8% 11.7% 0.84 (0.77-0.92) CV death 4.0% 5.1% 0.79 (0.69-0.91) MI 5.8% 6.9% 0.84 (0.75-0.95) Stroke 1.5% 1.3% 1.17 (0.91-1.52) All cause mortality 4.5% 5.9% 0.78 (0.69-0.89) In-stent thrombosis (11,289 pts with PCI/stenting) 1.3% 1.9% 0.67 (0.50-0.91) P-value ARR/NNT 0.0003 1.9%/53 0.0013 1.1%/91 0.0045 1.1%/91 0.22 0.0003 1.4%/72 0.0091 0.6%/167 Ticagrelor – Brilinta N Engl J Med 2009;361:1045-57. • No significant difference in the rates of major bleeding was found between the ticagrelor and clopidogrel groups (11.6% and 11.2%, respectively; P = 0.43) • Ticagrelor was associated with a higher rate of major bleeding not related to coronary-artery bypass grafting (4.5% vs. 3.8%, P = 0.03, ARI = 0.7%, NNH = 143) including more instances of fatal intracranial bleeding and fewer of fatal bleeding of other types. • In a genetic substudy of PLATO (n=10,285), the effects of ticagrelor compared to clopidogrel on thrombotic events and bleeding were not significantly affected by CYP2C19 genotype. Wayne Weart New Drug Update Part I
2 nd Annual Essentials in Primary Care Fall Conference Friday, November 11, 2011 PLATO: CV Death, MI, Stroke by maintenance aspirin dose in the US and outside the US Ticagrelor – Brilinta N Engl J Med 2009;361:1045-57 Wayne Weart New Drug Update Part I
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